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[颅内动脉粥样硬化性卒中患者斑块内出血的患病率及预测因素]

[Prevalence and predictors of intraplaque hemorrhage in stroke patients with intracranial atherosclerosis].

作者信息

Song X W, Wei C M, Xu W D, Wang L X, Zhao H L, Xu Y L, Zhao X H, Zheng Z Z, Wu J

机构信息

Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.

Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Sep 8;100(33):2622-2627. doi: 10.3760/cma.j.cn112137-20200107-00046.

Abstract

To investigate the prevalence and predictors of intraplaque hemorrhage (IPH) in ischemic stroke patients with intracranial atherosclerosis. Ischemic stroke patients with intracranial atherosclerosis who were consecutively admitted to Beijing Tsinghua Changgung Hospital from January 2017 to April 2018 were retrospectively analyzed. High-resolution magnetic resonance vessel wall imaging was used to assess atherosclerotic plaque characteristics of intracranial artery. Possible variables correlated with IPH were compared between IPH and no-IPH groups, as well as in symptomatic IPH and no symptomatic IPH groups. Logistic regression analysis was used to determine the predictors of all IPH and symptomatic IPH in intracranial artery. A total of 276 ischemic stroke patients with intracranial atherosclerosis were included, of which, 41.3% (114/276) were IPH-postive, and 28.1%(32/114) of them were symptomatic. In multivariate regression analysis, maximum wall thickness was independently associated with the presence of all IPH and symptomatic IPH (2.15, 95 (1.42-3.24) and 3.46, 95 (1.94-6.17), respectively). The prevalence of IPH in ischemic stroke patients with intracranial atherosclerosis is much higher than expected. Moreover, atherosclerosis plaque burden is independently associated with IPH, but it is non-specific in identifying symptomatic IPH.

摘要

探讨颅内动脉粥样硬化性缺血性卒中患者斑块内出血(IPH)的患病率及预测因素。对2017年1月至2018年4月连续入住北京清华长庚医院的颅内动脉粥样硬化性缺血性卒中患者进行回顾性分析。采用高分辨率磁共振血管壁成像评估颅内动脉粥样硬化斑块特征。比较IPH组和非IPH组以及有症状IPH组和无症状IPH组中与IPH可能相关的变量。采用逻辑回归分析确定颅内动脉所有IPH和有症状IPH的预测因素。共纳入276例颅内动脉粥样硬化性缺血性卒中患者,其中41.3%(114/276)为IPH阳性,其中28.1%(32/114)有症状。在多因素回归分析中,最大管壁厚度与所有IPH和有症状IPH的存在独立相关(分别为2.15,95%(1.42 - 3.24)和3.46,95%(1.94 - 6.17))。颅内动脉粥样硬化性缺血性卒中患者中IPH的患病率远高于预期。此外,动脉粥样硬化斑块负荷与IPH独立相关,但在识别有症状IPH方面不具有特异性。

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