Division of Geriatrics, University of Sao Paulo Medical School, Brazil.
Memory and Aging Center, University of California San Francisco, USA.
Atherosclerosis. 2018 Mar;270:218-223. doi: 10.1016/j.atherosclerosis.2017.12.015. Epub 2017 Dec 9.
Intracranial (IAD) and extracranial atherosclerotic diseases (EAD) have been mostly investigated using imaging methods. Autopsy studies allow for a direct and complete evaluation of the atherosclerotic disease. We aimed to investigate the frequency of IAD and EAD, their association, and related risk profiles in a large cross-sectional autopsy study.
We measured the intima-media thickness and stenosis of the common (CCA) and internal carotid arteries (ICA), using morphometric measurements. The main outcome was stenosis (≥50%) in the artery with the largest obstruction among the 12 cerebral arteries. We used multivariable logistic regression models to investigate the association between EAD and IAD.
In 661 participants (mean age = 71.3 ± 11.7 y, 51% male), stenosis was more common in IAD than in EAD (59% vs. 51%). EAD was associated with Caucasian race, hypertension, and smoking, while IAD was associated with older age, less years of education, hypertension, diabetes, and a previous history of stroke. Stenosis in CCA and ICA was associated with more than two times the odds of having stenosis in the intracranial arteries (CCA: OR = 2.32, 95% CI = 1.64; 3.28; ICA: OR = 2.51, 95% CI = 1.76; 3.57).
In this population-based autopsy study, IAD was common, even more common than EAD, but correlated with EAD.
颅内（IAD）和颅外动脉粥样硬化疾病（EAD）大多使用影像学方法进行研究。尸检研究可以直接、全面地评估动脉粥样硬化疾病。我们旨在通过一项大型的、基于尸检的横断面研究，调查 IAD 和 EAD 的发生率、它们之间的关联以及相关的风险概况。
我们使用形态计量学测量颈总动脉（CCA）和颈内动脉（ICA）的内膜中层厚度和狭窄程度。主要结果是 12 条脑动脉中阻塞最严重的动脉的狭窄程度（≥50%）。我们使用多变量逻辑回归模型来调查 EAD 和 IAD 之间的关联。
在 661 名参与者（平均年龄 71.3±11.7 岁，51%为男性）中，IAD 的狭窄比 EAD 更常见（59%比 51%）。EAD 与白种人、高血压和吸烟有关，而 IAD 与年龄较大、受教育年限较少、高血压、糖尿病和既往卒中史有关。CCA 和 ICA 的狭窄与颅内动脉狭窄的几率增加两倍以上有关（CCA：OR=2.32，95%CI=1.64；3.28；ICA：OR=2.51，95%CI=1.76；3.57）。
在这项基于人群的尸检研究中，IAD 很常见，甚至比 EAD 更常见，但与 EAD 相关。
