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中国中老年患者颈动脉迂曲与脑白质疏松症之间的显著关联。

Significant Association between Carotid Artery Kinking and Leukoaraiosis in Middle-Aged and Elderly Chinese Patients.

作者信息

Yu Ke, Zhong Tingting, Li Ling, Wang Junfeng, Chen Yang, Zhou Huadong

机构信息

Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China.

Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China.

出版信息

J Stroke Cerebrovasc Dis. 2015 May;24(5):1025-31. doi: 10.1016/j.jstrokecerebrovasdis.2014.12.030. Epub 2015 Mar 25.

Abstract

BACKGROUND

Leukoaraiosis (LA) and carotid artery morphologic variations are 2 common imaging manifestations. The purpose of this study was to determine whether carotid artery morphologic variations are correlated with LA.

METHODS

A total of 702 patients, aged 50 years or older, admitted to our hospital from November 1, 2013, to January 30, 2014, were prospectively enrolled in this study. All participants underwent magnetic resonance imaging to assess the presence and severity of LA. Carotid artery morphologic variations were classified into tortuosity, kinking, and coiling by computed tomography angiography. Logistic regression analyses were performed to examine the relationship between carotid artery morphologic variations, its components, and LA.

RESULTS

The frequency of hemisphere with LA and carotid artery with carotid artery morphologic variations was 49.9% and 70.3% in the cohort, respectively. Carotid kinking was associated with an increased risk of ipsilateral LA after multivariable adjustment (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.57-3.36 for left side; OR, 2.51; 95% CI: 1.68-3.74 for right side), whereas carotid tortuosity and coiling were not related to LA. Moreover, the prevalence of carotid kinking gradually increased with advancing grades of ipsilateral LA.

CONCLUSIONS

The present study demonstrated that carotid artery kinking may be associated with an increased risk of LA in middle-aged and elderly Chinese patients. Further prospective studies are needed to confirm these findings.

摘要

背景

脑白质疏松(LA)和颈动脉形态变异是两种常见的影像学表现。本研究的目的是确定颈动脉形态变异是否与LA相关。

方法

2013年11月1日至2014年1月30日期间入住我院的702例年龄在50岁及以上的患者被前瞻性纳入本研究。所有参与者均接受磁共振成像以评估LA的存在和严重程度。通过计算机断层血管造影将颈动脉形态变异分为迂曲、扭结和盘绕。进行逻辑回归分析以检验颈动脉形态变异及其组成部分与LA之间的关系。

结果

在该队列中,有LA的半球和有颈动脉形态变异的颈动脉的频率分别为49.9%和70.3%。多变量调整后,颈动脉扭结与同侧LA风险增加相关(优势比[OR],2.29;95%置信区间[CI],左侧为1.57 - 3.36;OR,2.51;95% CI:右侧为1.68 - 3.74),而颈动脉迂曲和盘绕与LA无关。此外,颈动脉扭结的患病率随着同侧LA分级的增加而逐渐升高。

结论

本研究表明,在中国中老年患者中,颈动脉扭结可能与LA风险增加相关。需要进一步的前瞻性研究来证实这些发现。

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