Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Brain Behav. 2022 Apr;12(4):e2521. doi: 10.1002/brb3.2521. Epub 2022 Mar 20.
Ischemic stroke (IS) caused by middle cerebral artery (MCA) disease is the most common type of IS caused by intracranial artery disease in the Chinese population. Hypertension and diabetes mellitus are the common risk factors of cerebral small vessel disease and large artery atherosclerosis (LAA). However, little is known about whether hypertension and diabetes mellitus had different correlations with the small artery occlusion (SAO) and LAA etiology of MCA disease. Therefore, our aim was to identify the predictors of the etiology of MCA disease.
We consecutively enrolled 967 patients with noncardiogenic IS in unilateral MCA territory. Vascular risk factors and the clinical-radiologic features of IS were analyzed. The etiology of IS were classified as SAO or LAA according to the Stop Stroke Study Trial of Org 10172 in Acute Stroke Treatment classification criteria. Multivariable logistic regression was used to identify the differences in the predictors between SAO and LAA etiology of MCA disease.
Multivariable logistic regression identified male and hypertension as the predictors of the SAO etiology of MCA disease, however diabetes mellitus, repeated transient ischemic attack before the stroke, gaze palsy, aphasia, headache at admission, and disability at discharge as the predictors of the LAA etiology of MCA disease.
Hypertension and diabetes mellitus are related with the different etiology of MCA disease.
由大脑中动脉（MCA）病变引起的缺血性脑卒中（IS）是中国人颅内动脉疾病中最常见的 IS 类型。高血压和糖尿病是脑小血管病和大动脉粥样硬化（LAA）的常见危险因素。然而，对于高血压和糖尿病与 MCA 疾病的小动脉闭塞（SAO）和 LAA 病因学之间是否存在不同的相关性，目前知之甚少。因此，我们的目的是确定 MCA 疾病病因的预测因素。
我们连续纳入 967 例单侧 MCA 区域非心源性 IS 患者。分析血管危险因素和 IS 的临床影像学特征。根据 Stop Stroke Study Trial of Org 10172 in Acute Stroke Treatment 分类标准，将 IS 的病因分为 SAO 或 LAA。多变量逻辑回归用于确定 MCA 疾病 SAO 和 LAA 病因之间预测因素的差异。
多变量逻辑回归确定男性和高血压是 MCA 疾病 SAO 病因的预测因素，而糖尿病、中风前重复短暂性脑缺血发作、眼球麻痹、失语、入院时头痛和出院时残疾是 MCA 疾病 LAA 病因的预测因素。
高血压和糖尿病与 MCA 疾病的不同病因有关。
