颅内颈动脉钙化与静脉溶栓后急性缺血性卒中预后的相关性
Correlation Between Intracranial Carotid Artery Calcification and Prognosis of Acute Ischemic Stroke After Intravenous Thrombolysis.
作者信息
Shen Yuan, Dong Zhifeng, Xu Gang, Zhong Jianguo, Pan Pinglei, Chen Zhipeng, Shi Haicun
机构信息
Department of Neurology, Yancheng Third People's Hospital, Yancheng, China.
Department of Neurology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China.
出版信息
Front Neurol. 2022 Apr 13;13:740656. doi: 10.3389/fneur.2022.740656. eCollection 2022.
OBJECTIVE
To investigate the correlation between prognosis and intracranial carotid artery calcification (ICAC) in patients with acute ischemic stroke (AIS) who receive intravenous thrombolysis (IVT).
METHODS
A total of 156 AIS patients who received IVT from March 2019 to March 2020 were enrolled. The modified Woodcock visual score was used to evaluate ICAC in nonenhanced head CT scans. Patients were divided into high calcification burden (HCB; score ≥3) and low calcification burden (LCB; score <3) groups. Demographic, laboratory, imaging and clinical data were compared between the two groups, and whether HCB was a prognostic factor was evaluated.
RESULTS
Compared with the LCB group, the HCB group had a higher incidence of atrial fibrillation (49.2 vs.22.1%, < 0.001) and coronary heart disease (24.6 vs. 10.0%, = 0.019) and higher serum homocysteine [15.31 (12.15, 17.50) vs. 14.40 (11.20, 16.20), = 0.036] and hemoglobin A1c (6.93 ± 1.77 vs. 6.37 ± 0.74, = 0.023) levels. Binary logistic regression analysis showed that atrial fibrillation (OR = 3.031, 95% CI: 1.312-7.006, = 0.009) and HbA1c (OR = 1.488, 95% CI: 1.050-2.109, = 0.026) were independent risk factors for ICAC. After adjusting for other risk factors, symptomatic-side and bilateral ICACs were independent risk factors for poor prognosis (OR = 1.969, 95% CI: 1.220-3.178, = 0.006), (OR = 1.354, 95% CI: 1.065-1.722, = 0.013) and mortality (OR = 4.245, 95% CI: 1.114-16.171, = 0.034), (OR = 2.414, 95% CI = 1.152-5.060, = 0.020) in patients with AIS who received IVT.
CONCLUSION
ICAC is closely related to the prognosis of acute ischemic stroke after intravenous thrombolysis.
目的
探讨接受静脉溶栓治疗的急性缺血性卒中（AIS）患者预后与颅内颈动脉钙化（ICAC）之间的相关性。
方法
纳入2019年3月至2020年3月期间接受静脉溶栓治疗的156例AIS患者。采用改良的伍德科克视觉评分法在非增强头部CT扫描中评估ICAC。患者分为高钙化负荷（HCB；评分≥3）组和低钙化负荷（LCB；评分<3）组。比较两组的人口统计学、实验室、影像学和临床数据，并评估HCB是否为预后因素。
结果
与LCB组相比，HCB组房颤（49.2%对22.1%，<0.001）和冠心病（24.6%对10.0%，=0.019）的发生率更高，血清同型半胱氨酸[15.31（12.15，17.50）对14.40（11.20，16.20），=0.036]和糖化血红蛋白A1c（6.93±1.77对6.37±0.74，=0.023）水平更高。二元逻辑回归分析显示，房颤（OR=3.031，95%CI：1.312 - 7.006，=0.009）和糖化血红蛋白A1c（OR=1.488，95%CI：1.050 - 2.109，=0.026）是ICAC的独立危险因素。在调整其他危险因素后，症状侧和双侧ICAC是接受静脉溶栓治疗的AIS患者预后不良（OR=1.969，95%CI：1.220 - 3.178，=0.006）、（OR=1.354，95%CI：1.065 - 1.722，=0.013）和死亡（OR=4.245，95%CI：1.114 - 16.171，=0.034）、（OR=2.414，95%CI = 1.152 - 5.060，=0.020）的独立危险因素。
结论
ICAC与静脉溶栓后急性缺血性卒中的预后密切相关。
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