Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan.
Department Radiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming University, Taipei, Taiwan.
J Neurol Sci. 2019 Sep 15;404:101-105. doi: 10.1016/j.jns.2019.07.022. Epub 2019 Jul 19.
Vertebrobasilar artery dissection(VBD) is a common etiology of posterior circulation stroke(PCS). However, the etiology of VBD itself remains unclear. The present study aimed to test whether inflammation is involved in the mechanism of VBD by evaluating its relationship with total and differential leukocyte counts.
Patients with PCS caused by VBD or by large artery atherosclerosis(LAA) were recruited between January 1, 2012 and December 31, 2014 from the Taipei Veterans General Hospital. Age- and sex-matched non-stroke(NS) volunteers were also included. Univariate and multivariate analyses were performed to compare total/differential leukocyte counts among VBD, LAA, and NS groups.
One-hundred-one patients with VBD [average age: 64.8(15.1) years; 77(76.2%) males], 70 with LAA [average age: 73.9(10.6) years; 44(62.9%) males], and 202 NS [average age: 64.8(15.1) years; 77(76.2%) males] patients were included in the present study. Compared with the NS and LAA groups, respectively, the VBD group had significantly higher total leukocyte and neutrophil counts and frequency of high leukocyte (>10,000 × 10/L) and high neutrophil (>8000 × 10/L) counts. Multivariate analyses, adjusted for age, sex, and vascular risk factors, showed that the VBD group, compared with the other groups, had an odds-ratio of 5.04 (95% confidence interval:2.43-10.43) and 5.90 (2.70-12.92) with respect to the prevalence of high leukocyte and high neutrophil counts.
VBD was associated with high leukocyte and neutrophil counts. Our results support that inflammation and neutrophil-related pathophysiology might be involved in the mechanism of VBD; however, the causal relationship would need further investigations.
椎基底动脉夹层（VBD）是后循环卒中（PCS）的常见病因。然而，VBD 本身的病因仍不清楚。本研究旨在通过评估其与总白细胞和分类白细胞计数的关系，来检验炎症是否参与 VBD 的发病机制。
2012 年 1 月 1 日至 2014 年 12 月 31 日，我们从台北荣民总医院招募了由 VBD 或大动脉粥样硬化（LAA）引起的 PCS 患者。还招募了年龄和性别相匹配的非卒中（NS）志愿者。进行单变量和多变量分析，以比较 VBD、LAA 和 NS 组之间的总/分类白细胞计数。
本研究共纳入 101 例 VBD 患者[平均年龄：64.8（15.1）岁；77（76.2%）名男性]、70 例 LAA 患者[平均年龄：73.9（10.6）岁；44（62.9%）名男性]和 202 例 NS 患者[平均年龄：64.8（15.1）岁；77（76.2%）名男性]。与 NS 和 LAA 组相比，VBD 组的总白细胞和中性粒细胞计数以及白细胞计数（>10,000×10/L）和中性粒细胞计数（>8000×10/L）较高的频率明显更高。经年龄、性别和血管危险因素校正的多变量分析显示，与其他组相比，VBD 组白细胞计数和中性粒细胞计数较高的优势比分别为 5.04（95%置信区间：2.43-10.43）和 5.90（2.70-12.92）。
VBD 与白细胞和中性粒细胞计数升高有关。我们的结果支持炎症和中性粒细胞相关的病理生理学可能参与 VBD 的发病机制；然而，因果关系需要进一步研究。
