无症状性颅内动脉粥样硬化狭窄对单发皮质下梗死患者临床结局的影响。
The impact of asymptomatic intracranial atherosclerotic stenosis on the clinical outcomes of patients with single subcortical infarction.
作者信息
Yang Yi, He Yue, Xu Yuhao, Han Wei, Shao Yuanwei, Zhao Tian, Yu Ming
机构信息
Department of Neurology, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
出版信息
Front Med (Lausanne). 2023 Sep 1;10:1249347. doi: 10.3389/fmed.2023.1249347. eCollection 2023.
BACKGROUND
The presence of parental arterial disease (PAD) is correlated with the outcomes of patients with a single subcortical infarction (SSI). Due to the relatively low incidence of PAD, the predictors of outcomes seem to be limited for SSI patients without PAD. This study aims to investigate the association between asymptomatic intracranial atherosclerotic stenosis (aIAS) and outcomes in patients with SSI and in the subgroup without PAD.
METHODS
Patients with SSI were consecutively enrolled. aIAS referred to a stenosis of ≥50% in intracranial arteries irrelevant to SSI by using magnetic resonance angiography. A poor outcome refers to a modified Ranking Scale >2 points at discharge.
RESULTS
In total, 298 participants were enrolled. The presence of aIAS could predict a poor outcome for all SSI patients [adjusted relative risk (aRR) = 2.14, 95% confidence interval (CI) = 1.17-3.93, = 0.014] and in the subgroup without PAD (aRR = 3.12, 95% CI = 1.47-6.62, = 0.003), but not in the subgroup with PAD. Compared with participants with neither aIAS nor PAD, the risk of a poor outcome increased approximately 2-fold in those with aIAS only (aRR = 2.95, 95% CI = 1.55-5.60, = 0.001) and in those with concomitant aIAS and PAD (aRR = 3.10, 95% CI = 1.62-5.95, = 0.001).
CONCLUSION
The presence of aIAS is a predictor of a poor outcome in SSI patients, especially in those without PAD.
背景
父母患有动脉疾病（PAD）与单个皮质下梗死（SSI）患者的预后相关。由于PAD的发病率相对较低，对于没有PAD的SSI患者，预后的预测因素似乎有限。本研究旨在探讨无症状颅内动脉粥样硬化狭窄（aIAS）与SSI患者及无PAD亚组患者预后之间的关联。
方法
连续纳入SSI患者。通过磁共振血管造影，aIAS指与SSI无关的颅内动脉狭窄≥50%。不良预后指出院时改良Rankin量表评分>2分。
结果
共纳入298名参与者。aIAS的存在可预测所有SSI患者的不良预后[调整后相对风险（aRR）=2.14，95%置信区间（CI）=1.17 - 3.93，P = 0.014]以及无PAD亚组患者的不良预后（aRR = 3.12，95%CI = 1.47 - 6.62，P = 0.003），但不能预测有PAD亚组患者的不良预后。与既无aIAS也无PAD的参与者相比，仅患有aIAS的参与者不良预后风险增加约2倍（aRR = 2.95，95%CI = 1.55 - 5.60，P = 0.001），同时患有aIAS和PAD的参与者不良预后风险增加约2倍（aRR = 3.10，95%CI = 1.62 - 5.95，P = 0.001）。
结论
aIAS的存在是SSI患者不良预后的预测因素，尤其是在没有PAD的患者中。
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