无症状韩国人群颅内动脉粥样硬化的患病率及相关危险因素。
Prevalence and risk factors of intracranial atherosclerosis in an asymptomatic korean population.
机构信息
Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
J Clin Neurol. 2006 Mar;2(1):29-33. doi: 10.3988/jcn.2006.2.1.29. Epub 2006 Mar 20.
BACKGROUND AND PURPOSE
Intracranial atherosclerosis (ICAS) is one of the major risk factors for ischemic stroke, particularly in Asian populations. We investigated the prevalence and risk factors of ICAS in asymptomatic subjects.
METHODS
We prospectively evaluated 835 asymptomatic Korean adults who voluntarily visited a tertiary referral hospital for a health screening examination that included brain magnetic resonance angiography. The subjects had no history of stroke or transient ischemic attacks; those who had potential cardiac sources of emboli were excluded. ICAS and extracranial atherosclerosis were defined as a reduction in luminal diameter of at least 50%. Vascular risk factors were screened through questionnaires, interviews, and examinations.
RESULTS
ICAS was found in 25 subjects (3.0%) and extracranial atherosclerosis was found in 4 patients (0.5%). No patient had combined lesions. ICAS was distributed in 31 arteries in 25 subjects: anterior cerebral arteries (5 subjects, 16%), middle cerebral arteries (16 subjects, 52%), posterior cerebral arteries (8 subjects, 26%), and distal internal carotid arteries (2 subjects, 7%). The ratio of ICAS of the anterior circulation (23 of 31 arteries with ICAS, 74%) to that of the posterior circulation (8 of 31 arteries with ICAS, 26%) was 3:1. The ratio of ICAS (23 of 27 arteries with atherosclerosis in the anterior circulation, 85%) to extracranial atherosclerosis (4 of 27 arteries with therosclerosis in the anterior circulation, 15%) was 6:1. An older age [odds ratio (OR)=1.05, 95% confidence interval (CI)=1.00-1.10] and hypertension (OR=2.41, 95% CI=1.01-5.72) were independent risk factors for ICAS.
CONCLUSIONS
ICAS is more prevalent than extracranial atherosclerosis among neurologically asymptomatic Korean adults. Subjects with ICAS are significantly older and have an increased frequency of hypertension compared to those subjects without atherosclerotic stenosis.
背景与目的
颅内动脉粥样硬化（ICAS）是缺血性卒中的主要危险因素之一，尤其在亚洲人群中。本研究旨在调查无症状人群中 ICAS 的患病率及其相关危险因素。
方法
前瞻性评估了 835 例自愿到三级转诊医院进行健康筛查的韩国无症状成年人，该筛查包括脑磁共振血管造影。研究对象无卒中或短暂性脑缺血发作病史；排除存在潜在心源性栓子来源的患者。ICAS 和颅外动脉粥样硬化定义为管腔直径减少至少 50%。通过问卷调查、访谈和检查筛查血管危险因素。
结果
25 例（3.0%）患者存在 ICAS，4 例（0.5%）患者存在颅外动脉粥样硬化，无患者同时存在两种病变。25 例患者的 31 条动脉存在 ICAS：前循环动脉 5 例（16%）、中动脉 16 例（52%）、后循环动脉 8 例（26%）和颈内动脉远端 2 例（7%）。前循环 ICAS （23/31 条动脉）与后循环 ICAS（31 条动脉中 8 条）的比例为 3:1。前循环动脉粥样硬化中 ICAS（23/27 条动脉）与颅外动脉粥样硬化（27 条动脉中 4 条）的比例为 6:1。年龄较大（比值比[OR]：1.05，95%置信区间[CI]：1.00-1.10）和高血压（OR：2.41，95%CI：1.01-5.72）是 ICAS 的独立危险因素。
结论
在韩国神经学无症状成年人中，ICAS 比颅外动脉粥样硬化更为常见。与无动脉粥样硬化狭窄的患者相比，ICAS 患者年龄更大，且高血压发病率更高。
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