Yang Qiong, Zeng Xiangzhu, Tang Lu, Liu Xiaolu, Xia Kailin, Gao Feng, Huang Xu, Li Nan, Fan Dongsheng
Department of Neurology, Peking University Third Hospital, Beijing, China.
Department of Radiology, Peking University Third Hospital, Beijing, China.
Stroke Vasc Neurol. 2025 Apr 29;10(2):e003477. doi: 10.1136/svn-2024-003477.
We investigated the association of alleles with CT-based cerebral amyloid angiopathy (CAA) markers including subarachnoid extension (SAE) and finger-like projection (FLP).
We included patients with acute primary supratentorial intracerebral haemorrhage (ICH) from a multicentre cohort in China. First, the association of with ICH location (lobar vs non-lobar) was evaluated. Next, the relationships of with SAE, FLP, and the coexistence of the two (SAE+FLP) were evaluated.
533 patients with supratentorial ICH were enrolled. Among them were 138 patients with lobar ICH and 395 with non-lobar ICH. Compared with the non-lobar group, ε4 (OR 1.894, 95% CI 1.138 to 3.154, p=0.014) and ε2/ε4 (OR 6.098, 95% CI 1.414 to 26.293, p=0.015) were associated with lobar ICH. With regard to CAA markers, ε2 was associated with SAE (OR 2.109, 95% CI 1.167 to 3.810, p=0.013), ε4 was associated with FLP and SAE+FLP (OR 3.026, 95% CI 1.353 to 6.767, p=0.007; OR 3.514, 95% CI 1.485 to 8.316, p=0.004, respectively) and ε2/ε4 was associated with all three factors (SAH: OR 7.599, 95% CI 1.764 to 32.734, p=0.006; FLP: OR 20.333, 95% CI 3.278 to 126.137, p=0.001; SAE+FLP: OR 30.568, 95% CI 4.460 to 209.503, p<0.001) after adjusting for age, and remained significant after adjusting for age and ICH volume.
In patients with spontaneous supratentorial ICH, ε2 and ε4 alleles were associated with SAE and FLP, respectively, suggesting allele-specific effects on CT markers of CAA and their potential mechanisms.
我们研究了等位基因与基于CT的脑淀粉样血管病（CAA）标志物的关联，这些标志物包括蛛网膜下腔扩展（SAE）和指状突起（FLP）。
我们纳入了来自中国一个多中心队列的急性原发性幕上脑出血（ICH）患者。首先，评估等位基因与ICH位置（脑叶性与非脑叶性）的关联。接下来，评估等位基因与SAE、FLP以及两者共存（SAE+FLP）的关系。
共纳入533例幕上ICH患者。其中138例为脑叶性ICH患者，395例为非脑叶性ICH患者。与非脑叶性组相比，ε4（比值比1.894，95%置信区间1.138至3.154，p=0.014）和ε2/ε4（比值比6.098，95%置信区间1.414至26.293, p=0.015）与脑叶性ICH相关。关于CAA标志物，在调整年龄后，ε2与SAE相关（比值比2.109，95%置信区间1.167至3.810，p=0.013），ε4与FLP以及SAE+FLP相关（比值比分别为3.026，95%置信区间1.353至6.767，p=0.007；3.514，95%置信区间1.485至8.316，p=0.004），ε2/ε4与所有三个因素相关（SAH：比值比7.599，95%置信区间1.764至32.734，p=0.006；FLP：比值比20.333，95%置信区间3.278至126.137，p=0.001；SAE+FLP：比值比30.568，95%置信区间4.460至209.503，p<0.001），在调整年龄和ICH体积后仍具有显著性。
在自发性幕上ICH患者中，ε2和ε4等位基因分别与SAE和FLP相关，提示等位基因对CAA的CT标志物具有特异性影响及其潜在机制。
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