Lv Pu, Jin Haiqiang, Liu Yuanyuan, Cui Wei, Peng Qing, Liu Ran, Sun Wei, Fan Chenghe, Teng Yuming, Sun Weiping, Huang Yining
Department of Neurology, Peking University First Hospital, Beijing, China.
PLoS One. 2016 Mar 2;11(3):e0149605. doi: 10.1371/journal.pone.0149605. eCollection 2016.
Stroke is the second most common cause of mortality in China. Although most subtypes of ischemic stroke share similar risk factors, they have different etiologies. Our study aimed to evaluate the different risk factor profiles between the stroke subtypes, lacunar infarcts (LI) and large-artery atherosclerosis (LAA), and clarify the characteristics of current acute ischemic stroke in China.
In this cross-sectional study, we analyzed the clinical characteristics of 1982 patients with acute ischemic stroke who were admitted to the neurology department at the Peking University First Hospital between 2007 and 2014. Ischemic stroke was further classified into LAA, LI, cardioembolism (CE) and undetermined causes of infarction (UDI) according to TOAST classification. Demographic characteristics, risk factors, as well as the findings of laboratory and imaging tests of 1773 patients with LAA and LI, were analyzed by univariate and multivariate logistic analysis.
Of the 1982 ischemic stroke patients included in this study, 1207 were diagnosed with LAA, 566 with LI, 173 with cardioembolism (CE) and 36 with undetermined causes of infarction (UDI). By comparing the risk factors in multivariate logistic regression analysis, hypertension [odds ratio (OR) = 1.832] and white matter leukoaraiosis (WML) (OR = 1.865) were found to be more strongly correlated with LI than LAA. Low density lipoprotein- cholesterol (LDL-c) (OR = 0.774) were more strongly related to LAA than LI.
This study found that hypertension and WML were more strongly correlated with LI than LAA. LDL-c was more strongly related to LAA than LI.
在中国，中风是第二大常见死因。尽管大多数缺血性中风亚型具有相似的危险因素，但它们的病因各不相同。我们的研究旨在评估腔隙性梗死（LI）和大动脉粥样硬化（LAA）这两种中风亚型之间不同的危险因素概况，并阐明中国当前急性缺血性中风的特征。
在这项横断面研究中，我们分析了2007年至2014年间北京大学第一医院神经内科收治的1982例急性缺血性中风患者的临床特征。根据TOAST分类，缺血性中风进一步分为LAA、LI、心源性栓塞（CE）和梗死原因不明（UDI）。对1773例LAA和LI患者的人口统计学特征、危险因素以及实验室和影像学检查结果进行单因素和多因素逻辑分析。
在本研究纳入的1982例缺血性中风患者中，1207例被诊断为LAA，566例为LI，173例为心源性栓塞（CE），36例为梗死原因不明（UDI）。通过多因素逻辑回归分析比较危险因素，发现高血压[比值比（OR）=1.832]和白质疏松症（WML）（OR = 1.865）与LI的相关性比与LAA的更强。低密度脂蛋白胆固醇（LDL-c）（OR = 0.774）与LAA的相关性比与LI的更强。
本研究发现，高血压和WML与LI的相关性比与LAA的更强。LDL-c与LAA的相关性比与LI的更强。
