Cupini L M, Pasqualetti P, Diomedi M, Vernieri F, Silvestrini M, Rizzato B, Ferrante F, Bernardi G
Clinica Neurologica, Ospedale S.Eugenio, Universita' di Roma Tor Vergata, Roma, Italy.
Stroke. 2002 Mar;33(3):689-94. doi: 10.1161/hs0302.103661.
Increases in the thickness of the intima and media of the carotid artery have been associated with an increased risk of myocardial infarction and stroke in subjects without a history of cardiovascular disease. Lacunar infarcts, one of the most common subtype of ischemic stroke, show unique pathological and clinicoradiological characteristics. The present study examines the relationship between vascular risk factors, including carotid artery intima-media thickness (IMT), and lacunar versus nonlacunar infarcts.
We collected data from patients with acute ischemic stroke admitted to hospital. Patients and 129 control subjects underwent B-mode ultrasonographic measurements of IMT of the common carotid artery. We examined the association of lacunar and nonlacunar infarcts with age, sex, and potential vascular risk factors.
Of 292 adult patients with an acute first-ever ischemic stroke, 96 were considered lacunar and 196 were considered nonlacunar strokes. We did not find a significantly different percentage of diabetes, smoking, hypertension, dyslipidemia, myocardial infarction, and previous transient ischemic attack between the 2 groups of patients. The multinomial logistic regression procedure selected carotid artery IMT and atrial fibrillation as the only independent factors able to discriminate between lacunar and nonlacunar patients. IMT values were significantly higher in patients with nonlacunar stroke versus both those with lacunar stroke and control subjects.
The present results indicate the usefulness of noninvasive measurement of IMT with ultrasonic techniques as a diagnostic tool that may help to identify different subtypes of ischemic stroke patients. The noninvasive measurements may have predictive power with respect to lacunar versus nonlacunar infarcts.
在无心血管疾病病史的受试者中，颈动脉内膜和中膜厚度增加与心肌梗死和中风风险增加相关。腔隙性梗死是缺血性中风最常见的亚型之一，具有独特的病理及临床放射学特征。本研究探讨包括颈动脉内膜中层厚度（IMT）在内的血管危险因素与腔隙性梗死和非腔隙性梗死之间的关系。
我们收集了入院的急性缺血性中风患者的数据。患者和129名对照受试者接受了颈总动脉IMT的B型超声测量。我们研究了腔隙性和非腔隙性梗死与年龄、性别及潜在血管危险因素之间的关联。
在292例首次发生急性缺血性中风的成年患者中，96例被认为是腔隙性梗死，196例被认为是非腔隙性中风。我们发现两组患者之间糖尿病、吸烟、高血压、血脂异常、心肌梗死及既往短暂性脑缺血发作的比例无显著差异。多项逻辑回归分析选择颈动脉IMT和心房颤动作为能够区分腔隙性和非腔隙性患者的唯一独立因素。非腔隙性中风患者的IMT值显著高于腔隙性中风患者和对照受试者。
目前的结果表明，使用超声技术无创测量IMT作为一种诊断工具可能有助于识别缺血性中风患者的不同亚型。这种无创测量对于腔隙性梗死和非腔隙性梗死可能具有预测价值。
