Li Mi-Mi, Lin You-Yu, Huang Yin-Hui, Zhuo Shi-Tu, Yang Mei-Li, Lin Hua-Song, Cai Ruo-Wei
Clin Lab. 2015;61(11):1727-35. doi: 10.7754/clin.lab.2015.150419.
To investigate the distribution of stenosis of intracranial and extracranial arteries of Han population patients suffering from cerebral infarction in the city of Quanzhou in Fujian and to determine the correlation of apolipoprotein A1 and apolipoprotein B with intracranial and extracranial atherosclerosis stenosis.
For this study, we enrolled patients with cerebral infarction between December 2009 and October 2012 at the Neurology Department of The Second Affiliated Hospital of Fujian Medical University. All patients were examined by computed tomography angiography (CTA). Past medical history, demographic data, and biochemical markers were collected. Multiple logistic regression analysis was used to study the association between apo A1, apo B, and cerebral atherosclerosis stenosis.
A total of 412 patients were included in this study. 137 cases (33.3%) were classified as the intracranial atherosclerosis stenosis (ICAS) group, 74 cases (18.0%) as the combined intracranial and extracranial atherosclerosis stenosis (COAS) group, 44 cases (0.7%) as the extracranial atherosclerosis stenosis (ECAS) group, and 157 cases (38.1%) as the non-cerebral atherosclerosis stenosis (NCAS) group. Middle cerebral arteries (43.8%) were the most common lesions of intracranial arterial atherosclerosis stenosis. Extracranial carotid stenosis (30.7%) were more likely to be stenoses in the extracranial internal carotid arteries. Compared with the NCAS group, apo B was significantly higher (p < 0.001), apo A1 was significantly lower in the ICAS group and COAS group (p = 0.02 and p = 0.030). Compared with the mild atherosclerosis stenosis group, apo B was higher in the severe extracranial atherosclerosis stenosis group (p = 0.03), apo A1 was lower in the severe intracranial atherosclerosis stenosis group (p < 0.001). The multiple logistic regression analyses showed that when apo A1 > 1.28 g/L, it was an independent protective factor of intracranial stenosis (OR, 0.39), apo B was an independent risk factor of the cerebral atherosclerosis stenosis group, and when apo B > 1.16, it is significantly associated with the cerebral atherosclerosis stenosis group (ICAS: OR, 6.41) (ECAS: OR, 5.15).
探讨福建泉州汉族脑梗死患者颅内及颅外动脉狭窄的分布情况，并确定载脂蛋白A1和载脂蛋白B与颅内及颅外动脉粥样硬化狭窄的相关性。
本研究纳入2009年12月至2012年10月在福建医科大学附属第二医院神经内科就诊的脑梗死患者。所有患者均行计算机断层扫描血管造影（CTA）检查。收集既往病史、人口统计学资料及生化指标。采用多因素logistic回归分析研究载脂蛋白A1、载脂蛋白B与脑动脉粥样硬化狭窄的关系。
本研究共纳入412例患者。137例（33.3%）为颅内动脉粥样硬化狭窄（ICAS）组，74例（18.0%）为颅内及颅外动脉粥样硬化联合狭窄（COAS）组，44例（0.7%）为颅外动脉粥样硬化狭窄（ECAS）组，157例（38.1%）为非脑动脉粥样硬化狭窄（NCAS）组。大脑中动脉（43.8%）是颅内动脉粥样硬化狭窄最常见的病变部位。颅外颈动脉狭窄（30.7%）在颅外颈内动脉更易发生狭窄。与NCAS组相比，ICAS组和COAS组的载脂蛋白B显著升高（p<0.001），载脂蛋白A1显著降低（p=0.02和p=0.030）。与轻度动脉粥样硬化狭窄组相比，重度颅外动脉粥样硬化狭窄组的载脂蛋白B升高（p=0.03），重度颅内动脉粥样硬化狭窄组的载脂蛋白A1降低（p<0.001）。多因素logistic回归分析显示，当载脂蛋白A1>1.28 g/L时，是颅内狭窄的独立保护因素（OR，0.39），载脂蛋白B是脑动脉粥样硬化狭窄组的独立危险因素，当载脂蛋白B>1.16时，与脑动脉粥样硬化狭窄组显著相关（ICAS：OR，6.41）（ECAS：OR，5.15）。
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