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大动脉炎患者脑梗死的危险因素:一项单中心病例对照研究

Risk factors for cerebral infarction in Takayasu arteritis: a single-centre case-control study.

作者信息

Kong Fang, Huang Xu, Su Li, Liao Qiuju, Wang Chunxiu, Zhao Yi

机构信息

Department of Rheumatology and Allergy, Xicheng District, Beijing, 100053, China.

Evidence-Based Medical Centre, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, 100053, China.

出版信息

Rheumatology (Oxford). 2021 Dec 24;61(1):281-290. doi: 10.1093/rheumatology/keab308.

Abstract

OBJECTIVES

We aimed to investigate the clinical features of Takayasu arteritis with cerebral infarction, and the risk factors for cerebral infarction.

METHODS

The study analysed 122 consecutive patients with Takayasu arteritis retrospectively. The clinical characteristics of Takayasu arteritis patients with and without cerebral infarction were compared. Binary logistic regression analysis was performed to determine risk factors for cerebral infarction in Takayasu arteritis patients.

RESULTS

Cerebral infarction was present in 42 (34.4%) of 122 patients with Takayasu arteritis. There were 33 patients with ischaemic stroke and 11 with asymptomatic lacunar infarction, including two patients with both types of infarction. The cerebral infarction group had a significantly higher proportion of males, higher prevalence of blurred vision, and higher Indian Takayasu Clinical Activity Score (ITAS) 2010 than the non-cerebral infarction group. Binary logistic regression analysis indicated that hyperlipidaemia [odds ratio (OR) 5.549, P=0.021], ITAS 2010 (OR 1.123, P= 0.023), number of involved arteries (OR 1.307, P=0.018), and middle cerebral artery (MCA) involvement (OR 4.013, P=0.029) were significantly associated with cerebral infarction in patients with Takayasu arteritis. Receiver operating characteristic curves indicated fair performance of the ITAS 2010 (>6) and number of involved arteries (> 7) for distinguishing Takayasu arteritis patients at risk of cerebral infarction from those without such risk.

CONCLUSION

Hyperlipidaemia, higher ITAS 2010, larger number of involved arteries, and MCA involvement are independent risk factors for cerebral infarction in Takayasu arteritis patients.

摘要

目的

我们旨在研究合并脑梗死的大动脉炎的临床特征以及脑梗死的危险因素。

方法

本研究对122例连续性大动脉炎患者进行回顾性分析。比较了有和无脑梗死的大动脉炎患者的临床特征。进行二元逻辑回归分析以确定大动脉炎患者脑梗死的危险因素。

结果

122例大动脉炎患者中有42例(34.4%)发生脑梗死。有33例缺血性卒中患者和11例无症状腔隙性梗死患者,其中2例同时患有这两种类型的梗死。与无脑梗死组相比,脑梗死组男性比例显著更高,视力模糊患病率更高,且2010年印度大动脉炎临床活动评分(ITAS)更高。二元逻辑回归分析表明,高脂血症[比值比(OR)5.549,P = 0.021]、ITAS 2010(OR 1.123,P = 0.023)、受累动脉数量(OR 1.307,P = 0.018)以及大脑中动脉(MCA)受累(OR 4.013,P = 0.029)与大动脉炎患者的脑梗死显著相关。受试者工作特征曲线表明,ITAS 2010(>6)和受累动脉数量(>7)在区分有脑梗死风险的大动脉炎患者和无此风险的患者方面表现尚可。

结论

高脂血症、较高的ITAS 2010、较多的受累动脉数量以及MCA受累是大动脉炎患者脑梗死的独立危险因素。

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