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慢性症状性颅内椎基底动脉狭窄患者的脑血管危险因素与侧支代偿的关系。

Association between Cerebrovascular Risk Factors and Collateral Compensation in Chronic Symptomatic Intracranial Vertebrobasilar Stenosis.

机构信息

School of Medicine, Nankai University, Tianjin, China.

Graduate School of Tianjin Medical University, Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.

出版信息

Eur Neurol. 2022;85(6):478-485. doi: 10.1159/000525372. Epub 2022 Jun 28.

DOI:10.1159/000525372
PMID:35764062
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9808775/
Abstract

INTRODUCTION

The level of collateral compensation plays a pivotal role in chronic symptomatic intracranial vertebrobasilar stenosis (IVBS). This study aimed to evaluate the association between cerebrovascular risk factors and collateral compensation in chronic symptomatic IVBS.

METHODS

This single-center cross-sectional study retrospectively reviewed 238 patients with angiographically demonstrated IVBS and divided them into good collateral compensation (GCC) group (collateral grade: 3-4, n = 110) and poor collateral compensation (PCC) group (collateral grade: 0-2, n = 128). The demographic information, laboratory tests, and clinical data of the two groups were compared and assessed using univariate logistic regression. Multivariate logistic regression was employed to analyze the independent related factors of collateral compensation.

RESULTS

Hyperlipidemia, high-density lipoprotein (HDL), and fasting blood glucose (FBG) were significantly different between the two groups. Multivariate logistic regression analysis revealed that HDL (odds ratio [OR]: 1.134, 95% confidence interval [CI]: 1.081-1.190), FBG (OR: 0.945, 95% CI: 0.925-0.964), and hyperlipidemia (OR: 0.261, 95% CI: 0.129-0.527) were statistically independent related factors of collateral compensation. The receiver-operating characteristic (ROC) analysis provided cutoff values of 34 mg/dL and 135 mg/dL for HDL and FBG associated with GCC and PCC.

CONCLUSION

Higher HDL levels are associated with higher incidence of GCC, whereas higher FBG levels and hyperlipidemia are associated with higher incidence of PCC.

摘要

简介

侧支代偿水平在慢性有症状颅内椎基底动脉狭窄(IVBS)中起着关键作用。本研究旨在评估脑血管危险因素与慢性有症状 IVBS 侧支代偿之间的关系。

方法

这是一项单中心回顾性横断面研究,共纳入 238 例血管造影显示 IVBS 的患者,根据侧支代偿分级(3-4 级为良好侧支代偿组,n=110;0-2 级为差侧支代偿组,n=128)将其分为两组。比较两组患者的一般资料、实验室检查及临床资料,并采用单因素 logistic 回归分析。采用多因素 logistic 回归分析侧支代偿的独立相关因素。

结果

两组患者的血脂、高密度脂蛋白(HDL)和空腹血糖(FBG)水平存在显著差异。多因素 logistic 回归分析显示,HDL(比值比[OR]:1.134,95%置信区间[CI]:1.081-1.190)、FBG(OR:0.945,95%CI:0.925-0.964)和高血脂(OR:0.261,95%CI:0.129-0.527)是侧支代偿的独立相关因素。受试者工作特征(ROC)曲线分析得出,HDL 和 FBG 的截断值分别为 34 mg/dL 和 135 mg/dL,与 GCC 和 PCC 相关。

结论

较高的 HDL 水平与 GCC 发生率较高相关,而较高的 FBG 水平和高血脂与 PCC 发生率较高相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b76/9808775/f6b354b44453/ene-0085-0478-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b76/9808775/3574b79aeaad/ene-0085-0478-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b76/9808775/f6b354b44453/ene-0085-0478-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b76/9808775/3574b79aeaad/ene-0085-0478-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b76/9808775/f6b354b44453/ene-0085-0478-g02.jpg

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本文引用的文献

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Cerebral Collateral Circulation: A Review in the Context of Ischemic Stroke and Mechanical Thrombectomy.脑侧支循环:缺血性卒中与机械取栓背景下的综述
World Neurosurg. 2019 Feb;122:33-42. doi: 10.1016/j.wneu.2018.10.066. Epub 2018 Oct 18.
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Relevance of the cerebral collateral circulation in ischaemic stroke: time is brain, but collaterals set the pace.
脑侧支循环在缺血性卒中中的相关性:时间就是大脑,但侧支循环决定速度。
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Variants of Rab GTPase-Effector Binding Protein-2 Cause Variation in the Collateral Circulation and Severity of Stroke.Rab GTPase效应蛋白结合蛋白2的变体导致侧支循环和中风严重程度的差异。
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Thirty-Day Outcome of a Multicenter Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China.中国症状性颅内动脉狭窄支架置入多中心注册研究的30天结果
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Increasing HDL levels by inhibiting cholesteryl ester transfer protein activity in rabbits with hindlimb ischemia is associated with increased angiogenesis.通过抑制后肢缺血兔体内胆固醇酯转运蛋白活性来提高高密度脂蛋白水平与血管生成增加有关。
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