Zhai G J, Xu Y, Yang X Y, Sheng X H, Xiao G D, Cao Y J
Department of Neurology, the Ninth People's Hospital of Suzhou, Suzhou 215200, China.
Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
Zhonghua Yi Xue Za Zhi. 2022 Oct 11;102(37):2950-2955. doi: 10.3760/cma.j.cn112137-20220106-00043.
To explore the related factors of internal border-zone (IBZ) infarcts in patients with symptomatic chronic internal carotid artery occlusion (CICAO). From January 2011 to May 2019, the symptomatic CICAO patients in the Second Affiliated Hospital of Soochow University and the Ninth People's Hospital of Suzhou were retrospectively analyzed. The patients were divided into IBZ group and non-IBZ group. The demographic data, laboratory examination and imaging data of the two groups were collected. Binary logistic regression analysis was used to identify the related factors of IBZ infarcts in patients with symptomatic CICAO. A total of 185 patients (147 males and 38 females) were finally enrolled, with a mean age of (65±11) years old. There were 64 and 121 cases in IBZ group and non-IBZ group, respectively. The ratio of patients with ophthalmic artery (OA) reflux in IBZ group was 64.1% (41/64), which was significantly higher than that in non IBZ group [47.8% (55/121), 0.037], while the ratio of patients with collateral compensation (ASTIN/SIR 3-4) in non-IBZ group was 66.1% (80/121), which was significantly higher than that in IBZ group [29.7% (19/64), 0.001]. Multivariate logistic regression analysis showed that history of cerebral infarction (2.233, 95%: 1.023-4.874), low density lipoprotein (LDL) (1.516, 95%: 1.006-2.285) and OA reflux (5.060, 95%: 1.160-22.081) were independent risk factors for IBZ infarcts in patients with symptomatic CICAO (all 0.05); while prothrombin international normalized ratio (INR) (0.010, 95%: 0.000-0.970) and collateral compensation (ASTIN/SIR 3-4) (0.172, 95%: 0.079-0.373) were protective factors (all 0.05). OA reflux, LDL, and history of cerebral infarction are independent risk factors for IBZ infarcts in patients with symptomatic CICAO, while INR and collateral compensation scores (ASTIN/SIR 3-4) are the protective factors.
探讨有症状的慢性颈内动脉闭塞（CICAO）患者发生内侧边界区（IBZ）梗死的相关因素。回顾性分析2011年1月至2019年5月苏州大学附属第二医院和苏州市第九人民医院的有症状CICAO患者。将患者分为IBZ组和非IBZ组。收集两组的人口统计学数据、实验室检查和影像学数据。采用二元logistic回归分析确定有症状CICAO患者发生IBZ梗死的相关因素。最终纳入185例患者（男147例，女38例），平均年龄（65±11）岁。IBZ组和非IBZ组分别有64例和121例。IBZ组眼动脉（OA）反流患者比例为64.1%（41/64），显著高于非IBZ组[47.8%（55/121），P=0.037]；而非IBZ组侧支循环代偿（ASTIN/SIR 3-4）患者比例为66.1%（80/121），显著高于IBZ组[29.7%（19/64），P=0.001]。多因素logistic回归分析显示，脑梗死病史（2.233，95%CI：1.023-4.874）、低密度脂蛋白（LDL）（1.516，95%CI：1.006-2.285）和OA反流（5.060，95%CI：1.160-22.081）是有症状CICAO患者发生IBZ梗死的独立危险因素（均P<0.05）；而凝血酶原国际标准化比值（INR）（0.010，95%CI：0.000-0.970）和侧支循环代偿（ASTIN/SIR 3-4）（0.172，95%CI：0.079-0.373）是保护因素（均P<0.05）。OA反流、LDL和脑梗死病史是有症状CICAO患者发生IBZ梗死的独立危险因素，而INR和侧支循环代偿评分（ASTIN/SIR 3-4）是保护因素。
