有症状腔隙性卒中与非叶性脑出血的风险概况。
Risk Profile of Symptomatic Lacunar Stroke Versus Nonlobar Intracerebral Hemorrhage.
作者信息
Morotti Andrea, Paciaroni Maurizio, Zini Andrea, Silvestrelli Giorgio, Del Zotto Elisabetta, Caso Valeria, Dell'Acqua Maria Luisa, Simone Anna Maria, Lanari Alessia, Costa Paolo, Poli Loris, De Giuli Valeria, Gamba Massimo, Ciccone Alfonso, Ritelli Marco, Di Castelnuovo Augusto, Iacoviello Licia, Colombi Marina, Agnelli Giancarlo, Grassi Mario, de Gaetano Giovanni, Padovani Alessandro, Pezzini Alessandro
机构信息
From the Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica (A.M., P.C., L.P., V.D.G., A. Padovani, A. Pezzini) and Sezione di Biologia e Genetica, Dipartimento di Medicina Molecolare e Traslazionale (M.R., M.C.), Università degli Studi di Brescia, Brescia, Italy; Stroke Unit, Divisione di Medicina Cardiovascolare, Università di Perugia, Perugia, Italy (M.P., V.C., G.A.); Stroke Unit, Clinica Neurologica, Nuovo Ospedale Civile "S. Agostino Estense", AUSL Modena, Modena, Italy (A.Z., A.M.S., M.L.D.A.); S.C. di Neurologia e S.S. di Stroke Unit, ASST di Mantova, Mantova, Italy (G.S., A.L., A.C.); U.O. di Recupero e Rieducazione Funzionale, IRCCS Fondazione Don Gnocchi, Rovato, Italy (E.D.Z.); Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Brescia, Italy (M.G.); Laboratorio di Epidemiologia Molecolare e Nutrizionale, Dipartimento di Epidemiologia e Prevenzione, IRCCS Istituto Neurologico Mediterraneo, NEUROMED, Pozzilli, Italy (A.D.C., L.I., G.d.G.); and Dipartimento di Scienze del Sistema Nervoso e del Comportamento, Unità di Statistica Medica e Genomica, Università di Pavia, Pavia, Italy (M.G.).
出版信息
Stroke. 2016 Aug;47(8):2141-3. doi: 10.1161/STROKEAHA.116.013722. Epub 2016 Jun 21.
BACKGROUND AND PURPOSE
Although lacunar stroke (LS) and deep intracerebral hemorrhage (dICH) represent acute manifestations of the same pathological process involving cerebral small vessels (small vessel disease), it remains unclear what factors predispose to one phenotype rather than the other at individual level.
METHODS
Consecutive patients with either acute symptomatic LS or dICH were prospectively enrolled as part of a multicenter Italian study. We compared the risk factor profile of the 2 subgroups using multivariable logistic regression.
RESULTS
During a time course of 9.5 years, 1931 subjects (1434 LS and 497 dICH; mean age, 71.3±13.3 years; males, 55.5%) qualified for the analysis. Current smoking was associated with LS (odds ratio [OR], 2.17; P<0.001). Conversely, dICH cases were more likely to be hypertensive (OR, 1.87; P<0.001), excessive alcohol consumers (OR, 1.70; P=0.001), and more frequently under treatment with warfarin (OR, 2.05; P=0.010) and statins (OR, 3.10; P<0.001). Hypercholesterolemia, diabetes mellitus, and antiplatelet treatment were not associated with a specific small vessel disease manifestation.
CONCLUSIONS
The risk factor profile of dICH differs from that associated with LS. This might be used for disease risk stratification at individual level.
背景与目的
尽管腔隙性卒中（LS）和深部脑出血（dICH）是涉及脑小血管（小血管疾病）的同一病理过程的急性表现，但在个体水平上，哪些因素易导致一种表型而非另一种表型仍不清楚。
方法
作为一项意大利多中心研究的一部分，前瞻性纳入了连续的急性症状性LS或dICH患者。我们使用多变量逻辑回归比较了这两个亚组的危险因素谱。
结果
在9.5年的时间里，1931名受试者（1434例LS和497例dICH；平均年龄71.3±13.3岁；男性占55.5%）符合分析条件。当前吸烟与LS相关（比值比[OR]，2.17；P<0.001）。相反，dICH病例更可能患有高血压（OR，1.87；P<0.001）、过量饮酒（OR，1.70；P=0.001），并且更频繁地接受华法林（OR，2.05；P=0.010）和他汀类药物治疗（OR，3.10；P<0.001）。高胆固醇血症、糖尿病和抗血小板治疗与特定的小血管疾病表现无关。
结论
dICH的危险因素谱与LS不同。这可用于个体水平的疾病风险分层。
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