Liu Yang, Fan Yuan-Teng, Liu Yu-Min, Wang Tao, Feng Hong-Liang, Liu Guang-Zhi, Mei Bin
Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
J Huazhong Univ Sci Technolog Med Sci. 2017 Feb;37(1):93-99. doi: 10.1007/s11596-017-1700-5. Epub 2017 Feb 22.
The theory of branch atheromatous disease (BAD) has been commonly underused in clinical practice and research since it was proposed in 1989. In this study, we sought to explore clinical characteristics of its substypes and biomarkers for prognosis of BAD. A total of 176 consecutive patients with BAD were classified into two groups: paramedianpontine artery group (PPA group, n=70) and lenticulostriate artery group (LSA group, n=106). Bivariate analyses were used to explore the relationship between white matter hyperintensities (WMHs), National Institutes of Health Stroke Scale (NIHSS) scores and prognosis evaluated by the modified Rank Scale (mRS) at 6th month after stroke. The differences in prevalence of diabetes mellitus and a history of ischemic heart disease were statistically significant between PPA group and LSA group (χ =8.255, P=0.004; χ =13.402, P<0.001). The bivariate analyses demonstrated a positive correlation between NIHSS and poor prognosis in patients with BAD and in the two subtype groups, and a positive correlation between WMHs and poor prognosis in the PPA group. It is concluded that a significantly higher prevalence of diabetes mellitus and a history of ischemic heart disease exist in the PPA group than in the LSA group. In addition, high grades of NIHSS scores imply poor prognosis in patients with BAD and in the two subtype groups. Moreover, WMHs are a positive predictor for poor prognosis in patients in the PPA group.
自1989年提出以来,分支动脉粥样硬化疾病(BAD)理论在临床实践和研究中一直未得到充分应用。在本研究中,我们试图探讨BAD各亚型的临床特征以及BAD预后的生物标志物。总共176例连续性BAD患者被分为两组:脑桥旁正中动脉组(PPA组,n = 70)和豆纹动脉组(LSA组,n = 106)。采用双变量分析来探讨白质高信号(WMHs)、美国国立卫生研究院卒中量表(NIHSS)评分与卒中后6个月采用改良Rank量表(mRS)评估的预后之间的关系。PPA组和LSA组之间糖尿病患病率和缺血性心脏病病史的差异具有统计学意义(χ² = 8.255,P = 0.004;χ² = 13.402,P < 0.001)。双变量分析表明,BAD患者及两个亚型组中NIHSS与预后不良呈正相关,PPA组中WMHs与预后不良呈正相关。结论是,PPA组中糖尿病患病率和缺血性心脏病病史显著高于LSA组。此外,BAD患者及两个亚型组中NIHSS评分高意味着预后不良。而且,WMHs是PPA组患者预后不良的阳性预测指标。