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中国山东匡村无症状性颅内动脉狭窄研究:队列特征。

Kongcun Town Asymptomatic Intracranial Artery Stenosis study in Shandong, China: cohort profile.

机构信息

Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, China.

Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China.

出版信息

BMJ Open. 2020 Jul 13;10(7):e036454. doi: 10.1136/bmjopen-2019-036454.

Abstract

PURPOSE

The population-based Kongcun Town Asymptomatic Intracranial Artery Stenosis (KT-aICAS) study aims to investigate the prevalence of aICAS and major cardiovascular risk factors (CRFs) or biomarkers related to the development and prognosis of aICAS.

PARTICIPANTS

The KT-aICAS study included 2311 rural residents who were aged ≥40 years and living in Kongcun Town, Shandong Province, China. Baseline examination was conducted from October 2017 to October 2018, during which information on demographics, socioeconomics, personal and family medical history, and lifestyle factors was collected through face-to-face interviews, physical examination and blood tests. aICAS was initially screened using transcranial Doppler examination and then diagnosed using magnetic resonance angiography. Atherosclerosis in carotid arteries was diagnosed via carotid ultrasonography. High-resolution MRI was further used to evaluate the vessel wall of aICAS. Neuropsychological assessments were performed in the participants diagnosed with aICAS and the age-matched and sex-matched controls.

FINDINGS TO DATE

Of the 2311 participants, 2027 (87.7%) completed the diagnostic procedure and aICAS was detected in 154 persons, resulting in an overall prevalence of 7.6%. The prevalence of aICAS increased with advancing age from 5.1% in participants aged 40-49 years to 12.7% in those aged ≥70 years (p<0.001). aICAS was detected in 305 intracranial arteries, including 221 (72.5%) in the anterior circulation and 84 (27.5%) in the posterior circulation (p<0.001). In addition, major CRFs were highly prevalent among middle-aged and elderly rural dwellers who were free of clinical stroke.

FUTURE PLANS

Follow-up examinations will be performed every 3 years following the baseline examination. This study will increase our knowledge about the natural history of aICAS and facilitate studies of aICAS-associated disorders among rural-dwelling Chinese adults, such as ischaemic stroke and vascular cognitive impairment.

TRIAL REGISTRATION NUMBER

ChiCTR1800017197.

摘要

目的

基于人群的匡村无症状颅内动脉狭窄(KT-aICAS)研究旨在调查 aICAS 的患病率以及与 aICAS 的发生和预后相关的主要心血管危险因素(CRFs)或生物标志物。

参与者

KT-aICAS 研究纳入了 2311 名居住在中国山东省匡村的年龄≥40 岁的农村居民。基线检查于 2017 年 10 月至 2018 年 10 月进行,通过面对面访谈、体格检查和血液检查收集了人口统计学、社会经济学、个人和家族病史以及生活方式因素的信息。使用经颅多普勒检查初步筛查 aICAS,然后使用磁共振血管造影诊断。通过颈动脉超声诊断颈动脉粥样硬化。进一步使用高分辨率 MRI 评估 aICAS 的血管壁。对诊断为 aICAS 的参与者以及年龄和性别匹配的对照组进行神经心理学评估。

目前的研究结果

在 2311 名参与者中,有 2027 名(87.7%)完成了诊断程序,154 名参与者检出 aICAS,总体患病率为 7.6%。aICAS 的患病率随年龄增长而增加,从 40-49 岁年龄组的 5.1%增加到≥70 岁年龄组的 12.7%(p<0.001)。在 305 条颅内动脉中检出 aICAS,其中前循环 221 条(72.5%),后循环 84 条(27.5%)(p<0.001)。此外,在无临床脑卒中的中老年农村居民中,主要 CRFs 患病率很高。

未来计划

基线检查后每 3 年进行一次随访检查。本研究将增加我们对 aICAS 自然史的认识,并促进对中国农村成年人与 aICAS 相关疾病的研究,如缺血性脑卒中血管性认知障碍。

试验注册号

ChiCTR1800017197。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4931/7359188/0b92791a8339/bmjopen-2019-036454f01.jpg

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