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无症状性脑梗死与缺血性脑卒中患者颈动脉虹吸部钙化相关。

Silent brain infarction is associated with carotid siphon calcification in ischemic stroke patients.

机构信息

Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China.

Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China.

出版信息

Neuroimage Clin. 2022;35:103050. doi: 10.1016/j.nicl.2022.103050. Epub 2022 May 18.

Abstract

BACKGROUND

Silent brain infarction (SBI) had a higher prevalence in ischemic stroke patients than healthy population. Intracranial artery calcification, as the important component of atherosclerosis, is a known risk factor of ischemic stroke. Whether it is also the risk factor of SBI is uncertain. We aimed to assess the association between SBI and carotid siphon calcification (CSC) in ischemic stroke patients.

METHODS

We retrospectively collected consecutive data of acute ischemic stroke patients with and without SBI by Magnetic Resonance Imaging (MRI) and calcification using non-contrast Computerized Tomography (NCCT). We used a histopathologically validated method to score the circularity, thickness, and morphology of calcification. Clinical characteristics, prevalence and pattern (intimal and medial) of CSC were compared between patients with and without SBI. The association of CSC and SBI was investigated by logistic regression analysis.

RESULTS

Totally, 303 acute ischemic stroke patients were enrolled, of whom 260 (85.8%) had CSC. Patients with SBI were older (64.5 ± 10.4 years vs. 61.3 ± 12.1 years, P = 0.032), had a higher proportion of hypertension (77.5% vs. 65.7%, P = 0.035). Of the 260 CSC patients, there's no significant difference except for hyperlipidemia between patients with SBI and without SBI. The prevalence of intimal pattern of CSC was higher in those with SBI (adjusted odds ratio 2.42, 95% CI 1.219-4.794).

CONCLUSIONS

Patients with SBI at acute phase of ischemic stroke have more risk factors than mentioned previously. SBI associated with the intimal pattern of CSC which relate to the atherosclerosis process in symptomatic ischemic stroke patients.

摘要

背景

与健康人群相比,无症状性脑梗死(SBI)在缺血性脑卒中患者中更为常见。颅内动脉钙化作为动脉粥样硬化的重要组成部分,是已知的缺血性脑卒中危险因素。但它是否也是 SBI 的危险因素尚不确定。本研究旨在评估 SBI 与缺血性脑卒中患者颈动脉虹吸段钙化(CSC)之间的相关性。

方法

我们通过磁共振成像(MRI)和非对比计算机断层扫描(NCCT)回顾性地收集了急性缺血性脑卒中患者有无 SBI 的连续数据,并使用组织病理学验证的方法对钙化的圆度、厚度和形态进行评分。比较了有无 SBI 的患者 CSC 的临床特征、患病率和形态(内膜型和中膜型)。采用 logistic 回归分析探讨 CSC 与 SBI 的相关性。

结果

共纳入 303 例急性缺血性脑卒中患者,其中 260 例(85.8%)存在 CSC。SBI 患者年龄更大(64.5±10.4 岁 vs. 61.3±12.1 岁,P=0.032),高血压比例更高(77.5% vs. 65.7%,P=0.035)。在 260 例 CSC 患者中,除了血脂异常,SBI 患者与无 SBI 患者之间没有显著差异。在有 SBI 的患者中,CSC 的内膜型患病率更高(校正比值比 2.42,95%CI 1.219-4.794)。

结论

处于急性缺血性脑卒中阶段的 SBI 患者具有更多的危险因素。SBI 与症状性缺血性脑卒中患者的动脉粥样硬化过程中 CSC 的内膜型有关。

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