Saxena Yogesh, Saxena Vartika, Mittal Manish, Srivastava Malini, Raghuvanshi Shailendra
Department of Physiology, Himalayan Institute of Medical Sciences, SRH University, Dehradun, India.
Community and Family Medicine, AIIMS, Rishikesh, India.
Ann Neurosci. 2017 May;24(1):5-11. doi: 10.1159/000464417. Epub 2017 Apr 21.
Ischemic stroke is often a sequel of atherosclerotic risk factors. Carotid intima-media thickness (CIMT) is a surrogate marker of early atherosclerotic changes.
It was hypothesized that CIMT is associated with ischemic stroke in adults across all ages.
A case control study was performed on 163 diagnosed cases of first-time ischemic stroke and age-(±1 SD) and gender-matched healthy control attendants reporting at a tertiary care hospital. Data were collected on atherosclerotic risk factors for ischemic stroke. CIMT from both the carotids was measured using carotid vascular Doppler. The demographic profile and CIMT with atherosclerotic risk factors of cases and controls across different age groups were compared using unpaired test if they passed the test of normality, else the Mann-Whitney test was used. OR for vascular risk factors for the development of stroke was calculated. The relationship of CIMT to atherosclerotic risk factors was analyzed by using Spearman correlation and regression analysis. The level of significance was set at 0.05.
Age-specific value of CIMT was significantly higher in stroke cases than in age-matched controls across all age groups. Right CIMT, along with the history of hypertension (HTN; OR 2.3), are important risk factors for ischemic stroke in the younger age group (20-40 years). With increasing age along with the history of HTN and right CIMT (OR >7), presence of plaque (OR 6.3) and daily smoking (OR 5.1) are also significant risk factors. CIMT is significantly related to the daily alcohol and smoking intake and the presence of plaques. Right CIMT is positively related to increasing age in normal population ( = 0.041; < 0.001).
Right CIMT and comorbid HTN are significant risk factors associated with the development of ischemic stroke across all adult age groups.
缺血性中风常为动脉粥样硬化危险因素的后果。颈动脉内膜中层厚度（CIMT）是早期动脉粥样硬化改变的替代标志物。
假设CIMT与各年龄段成年人的缺血性中风相关。
在一家三级护理医院对163例首次缺血性中风确诊病例以及年龄（±1标准差）和性别匹配的健康对照者进行病例对照研究。收集缺血性中风的动脉粥样硬化危险因素数据。使用颈动脉血管多普勒测量双侧颈动脉的CIMT。对不同年龄组病例和对照的人口统计学特征以及伴有动脉粥样硬化危险因素的CIMT进行比较，若符合正态性检验则使用非配对t检验，否则使用曼 - 惠特尼检验。计算中风发生的血管危险因素的比值比（OR）。通过Spearman相关性和回归分析分析CIMT与动脉粥样硬化危险因素的关系。显著性水平设定为0.05。
在所有年龄组中，中风病例的CIMT年龄特异性值均显著高于年龄匹配的对照组。右侧CIMT以及高血压病史（HTN；OR 2.3）是年轻年龄组（20 - 40岁）缺血性中风的重要危险因素。随着年龄增长，伴有高血压病史、右侧CIMT（OR >7）、斑块存在（OR 6.3）和每日吸烟（OR 5.1）也是显著的危险因素。CIMT与每日酒精和吸烟摄入量以及斑块存在显著相关。在正常人群中，右侧CIMT与年龄增长呈正相关（r = 0.041；P < 0.001）。
右侧CIMT和合并高血压是所有成年年龄组缺血性中风发生的显著危险因素。
