Mei Bin, Liu Guang-Zhi, Yang Yang, Liu Yu-Min, Cao Jiang-Hui, Zhang Jun-Jian
Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
J Huazhong Univ Sci Technolog Med Sci. 2015 Dec;35(6):885-890. doi: 10.1007/s11596-015-1523-1. Epub 2015 Dec 16.
Based on the recently proposed Chinese ischemic stroke subclassification (CISS) system, intracranial branch atheromatous disease (BAD) is divided into large artery atherosclerosis (LAA) and penetrating artery disease (PAD). In the current retrospective analysis, we compared the general characteristics of BAD-LAA with BAD-PAD, BAD-LAA with non-BAD-LAA and BAD-PAD with non-BAD-PAD. The study included a total of 80 cases, including 45 cases of BAD and 35 cases of non-BAD. Subjects were classified using CISS system: BAD-LAA, BAD-PAD, non-BAD-LAA and non-BAD-PAD. In addition to analysis of general characteristics, the correlation between the factors and the two subtypes of BAD was evaluated. The number of cases included in the analysis was: 32 cases of BAD-LAA, 13 cases of BAD-PAD, 21 cases of non-BAD-LAA, and 14 cases of non-BAD-PAD. Diabetes mellitus affected more non-BAD-LAA patients than BAD-LAA patients (P=0.035). In comparison with non-BAD-PAD, patients with BAD-PAD were younger (P=0.040), had higher initial NIHSS score (P<0.001) and morbidity of ischemic heart disease (P=0.033). Within patients with BAD, the PAD subtype was associated with smoking (OR=0.043; P=0.011), higher low-density lipoprotein (OR=5.339; P=0.029), ischemic heart disease (OR=9.383; P=0.047) and diabetes mellitus (OR=12.59; P=0.020). It was concluded that large artery atherosclerosis was the primary mechanism of BAD. The general characteristics showed no significant differences between the CISS subtypes of LAA and PAD within BAD, as well as between the BAD and non-BAD within LAA subtype. Several differences between PAD subtypes of BAD and non-BAD were revealed.
基于最近提出的中国缺血性卒中亚型分类（CISS）系统，颅内分支动脉粥样硬化性疾病（BAD）分为大动脉粥样硬化（LAA）和穿支动脉疾病（PAD）。在本次回顾性分析中，我们比较了BAD-LAA与BAD-PAD、BAD-LAA与非BAD-LAA以及BAD-PAD与非BAD-PAD的一般特征。该研究共纳入80例病例，其中BAD 45例，非BAD 35例。根据CISS系统将受试者分为：BAD-LAA、BAD-PAD、非BAD-LAA和非BAD-PAD。除分析一般特征外，还评估了各因素与BAD两种亚型之间的相关性。纳入分析的病例数为：BAD-LAA 32例、BAD-PAD 13例、非BAD-LAA 21例和非BAD-PAD 14例。糖尿病在非BAD-LAA患者中的影响比BAD-LAA患者更多（P = 0.035）。与非BAD-PAD相比，BAD-PAD患者更年轻（P = 0.040），初始美国国立卫生研究院卒中量表（NIHSS）评分更高（P < 0.001），缺血性心脏病发病率更高（P = 0.033）。在BAD患者中，PAD亚型与吸烟（比值比[OR]=0.043；P = 0.011）、更高的低密度脂蛋白（OR = 5.339；P = 0.029）、缺血性心脏病（OR = 9.383；P = 0.047）和糖尿病（OR = 12.59；P = 0.020）相关。得出的结论是，大动脉粥样硬化是BAD的主要机制。一般特征显示，BAD内LAA和PAD的CISS亚型之间，以及LAA亚型内BAD和非BAD之间无显著差异。揭示了BAD和非BAD的PAD亚型之间的一些差异。
