Zhou Fengkun, Tang Jingqun, Li Pingping, Liao Bao, Qin Chao
Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning 5320021, China.
Ann Palliat Med. 2020 Mar;9(2):256-263. doi: 10.21037/apm.2020.02.32. Epub 2020 Mar 2.
Previous studies have demonstrated differences in the distribution of intracranial and/or extracranial atherosclerosis (I-ECAS) by region and race. Despite this, few studies have examined the distribution of arterial stenosis in ischemic stroke patients of the Zhuang population in Guangxi, China. We therefore aimed to investigate the distribution of cerebrovascular stenosis in ischemic stroke patients across different ethnicities in Guangxi province. A total of 1,101 patients were divided into 2 groups according to their ethnicity: the Zhuang group and Han group. All patients underwent 64-slice spiral computed tomographic angiography (CTA) scanning to document the presence of intracranial or extracranial stenosis. Results showed that: (I) intracranial atherosclerosis (ICAS) a higher incidence of ECAS (51.1% vs. 48.9%); (II) I-ECAS was the most common lesion type, followed by ICAS; (III) Zhuang patients had a higher rate of ECAS ( 20.2% vs. 15.2%, P=0.047) and a lower rate of I-ECAS (35.8% vs. 42.3%, P=0.041) than that of the Han group. Furthermore, Zhuang patients had a higher percentage of stenosis in the posterior circulation (23.0% vs. 13.1%, P<0.001) and a lower percentage of stenosis in the anterior circulation (29.3% vs. 41.5%, P<0.001) than Han patients; (IV) large artery atherosclerosis (LAA) was the most commonly identified cause of stroke, and the Zhuang group had a lower proportion of LAA than the Han group (47.7% vs. 55.4%; P=0.020); (V) smoking and drinking were independent risk factors for ICAS; older age, male gender, and drinking were independent risk factors for ECAS; older age, male gender, hypertension, and drinking were independent risk factors for I-ECAS; age, hypertension, diabetes, hyperlipidemia, smoking, and drinking were independent risk factors for LAA. These outcomes indicate that there are ethnicity differences in the distribution of cerebrovascular stenosis in Guangxi. The variability in the risk factors involved may explain the variation in the distribution of cerebral atherosclerosis between ethnic groups.
以往的研究表明，颅内和/或颅外动脉粥样硬化（I-ECAS）的分布存在地区和种族差异。尽管如此，很少有研究调查过中国广西壮族缺血性脑卒中患者的动脉狭窄分布情况。因此，我们旨在调查广西不同民族缺血性脑卒中患者的脑血管狭窄分布情况。总共1101例患者根据其民族分为两组：壮族组和汉族组。所有患者均接受了64层螺旋计算机断层血管造影（CTA）扫描，以记录颅内或颅外狭窄的情况。结果显示：（I）颅内动脉粥样硬化（ICAS）的发生率高于颅外动脉粥样硬化（ECAS）（51.1%对48.9%）；（II）I-ECAS是最常见的病变类型，其次是ICAS；（III）壮族患者的颅外动脉粥样硬化发生率高于汉族患者（20.2%对15.2%，P=0.047），而I-ECAS发生率低于汉族患者（35.8%对42.3%，P=0.041）。此外，壮族患者后循环狭窄的百分比高于汉族患者（23.0%对13.1%，P<0.001），前循环狭窄的百分比低于汉族患者（29.3%对41.5%，P<0.001）；（IV）大动脉粥样硬化（LAA）是最常见的卒中病因，壮族组LAA的比例低于汉族组（47.7%对55.4%；P=0.020）；（V）吸烟和饮酒是ICAS的独立危险因素；年龄较大、男性和饮酒是ECAS的独立危险因素；年龄较大、男性、高血压和饮酒是I-ECAS的独立危险因素；年龄、高血压、糖尿病、高脂血症、吸烟和饮酒是LAA的独立危险因素。这些结果表明，广西脑血管狭窄的分布存在民族差异。所涉及的危险因素的变异性可能解释了不同民族之间脑动脉粥样硬化分布的差异。
