[1]王秋丽〓杨兴丹〓张航〓李国锋〓刘晨菲.伴与不伴脑动脉血管壁钙化的颈动脉粥样硬化患者的临床特征及预后分析[J].卒中与神经疾病杂志,2023,30(03):278-282.[doi:10.3969/j.issn.1007-0478.2023.03.009]
　Wang Qiuli,Yang Xingdan,Zhang Hang,et al.Differences in clinical characteristics and prognosis of patients with carotid atherosclerosis with and without cerebral artery vascular wall calcification[J].Stroke and Nervous Diseases,2023,30(03):278-282.[doi:10.3969/j.issn.1007-0478.2023.03.009]
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伴与不伴脑动脉血管壁钙化的颈动脉粥样硬化患者的临床特征及预后分析()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第30卷
期数:
2023年03期
页码:
278-282
栏目:
论著
出版日期:
2023-06-20

文章信息/Info

Title:
Differences in clinical characteristics and prognosis of patients with carotid atherosclerosis with and without cerebral artery vascular wall calcification
文章编号:
1007-0478(2023)03-0278-05
作者:
王秋丽〓杨兴丹〓张航〓李国锋〓刘晨菲
054000 河北省邢台市第三医院[王秋丽;杨兴丹;张航;李国锋（通信作者）;刘晨菲]
Author(s):
Wang Qiuli;  Yang Xingdan;  Zhang Hang;  et al.
The Third Hospital of Xingtai, Hebei Province 054000
关键词:
颈动脉粥样硬化; 脑动脉; 血管壁钙化; 临床特征; 预后
Keywords:
Carotid atherosclerosis; Cerebral artery; Vessel wall calcification; Clinical features; Prognosis
分类号:
R743.32
DOI:
10.3969/j.issn.1007-0478.2023.03.009
文献标志码:
A
摘要:
目的 探讨伴与不伴脑动脉血管壁钙化的颈动脉粥样硬化（Carotid atherosclerosis，CAS）患者的临床特征及预后情况。 方法 选取本院2016年8月-2021年8月CAS患者256例，均行头颈部电子计算机断层扫描血管造影（Computerized tomography angiography，CTA）检查，分析脑动脉血管壁钙化情况，分为伴钙化组与不伴钙化组，对比2组临床特征，分析脑动脉血管壁钙化与临床特征的关系，并于1年后评估2组预后情况，评价脑动脉血管壁钙化对预后的影响。 结果 256例CAS患者中血管壁钙化85例，总发生率为33.20%，其中进展性钙化32例，占总钙化的37.65%。伴钙化组年龄、体质量指数（Body mass index，BMI）、合并高血压病、糖尿病、冠状动脉疾病、吸烟史比例、CAS程度、颈动脉狭窄程度、颈动脉硬化斑块面积、颈动脉内膜中层厚度（Carotid intima-media thickness，CIMT）、低密度脂蛋白胆固醇（Low density lipoprotein cholesterol，LDLC）、同型半胱氨酸（Homocysteine，Hcy）、纤维蛋白原（Fibrinogen，FIB）、D-二聚体（D-dimer，D-D）水平高于不伴钙化组（P＜0.05）；Spearman相关性分析显示，脑动脉血管壁钙化与CAS患者年龄、BMI、高血压病、糖尿病、冠状动脉疾病、吸烟史比例、CAS程度、颈动脉狭窄程度、颈动脉硬化斑块面积、CIMT，LDLC，Hcy，FIB，D-D呈正相关（r均>0.417，P＜0.05）；随访1年，伴钙化组失访1例，不伴钙化组失访2例，伴钙化组脑血管事件发生率23.81%（20/84）高于不伴钙化组10.06%（17/169）（P＜0.05）；危险度分析显示，伴脑动脉血管壁钙化的CAS患者发生脑血管事件的风险是不伴脑动脉血管壁钙化患者的2.885倍，95%可信区间为1.592～5.229，P=0.001。 结论 伴与不伴脑动脉血管壁钙化CAS患者的多项临床特征存在明显差异，伴血管壁钙化会加快病情进展，增加脑血管事件发生风险，临床应及早给予合理性的防治措施。
Abstract:
Objective To investigate the differences in clinical characteristics of patients with carotid atherosclerosis (CAS) with and without cerebral artery vascular wall calcification and to analyze the comparative prognosis. Methods 256 patients with CAS from August 2016 to August 2021 in our hospital were selected, all of whom underwent CT angiography (CTA) of the head and neck, and the calcification of the cerebral artery vascular wall was counted and divided into the group with calcification and the group without calcification, and the clinical characteristics of the two groups were compared to analyze the relationship between calcification of the cerebral artery vascular wall and clinical characteristics, and the prognosis of the two groups was counted after 1 year to evaluate the effect of calcification of the cerebral artery vascular wall on prognosis. Results There were 85 cases of vascular wall calcification in 256 patients with CAS, with an overall incidence of 33.20%, including 32 cases of progressive calcification, accounting for 37.65% of the total calcification. The age, BMI, combined hypertension, diabetes mellitus, coronary artery disease, proportion of smoking history, degree of CAS, degree of carotid stenosis, carotid atherosclerotic plaque area, CIMT, LDL-C, Hcy, FIB, and D-D levels were higher in the group with calcification than in the group without calcification (P<0.05); spearman correlation analysis showed that cerebral artery vascular wall calcification was associated with age, BMI, hypertension, diabetes mellitus, coronary artery disease, and smoking history in patients with CAS. BMI, hypertension, diabetes mellitus, coronary artery disease, smoking history, degree of CAS, degree of carotid stenosis, carotid atherosclerotic plaque area, CIMT, LDL-C, Hcy, FIB, and D-D were positively correlated (P<0.05). At 1 year follow-up, one case was lost in the group with calcification and two cases were lost in the group without calcification, and the incidence of cerebrovascular events was 23.81% (20/84) higher in the group with calcification than in the group without calcification (10.06% (17/169) (P<0.05); the risk of cerebrovascular events was 2.885 times higher in CAS patients with cerebral artery vascular wall calcification than in patients without cerebral artery vascular wall calcification in the risk analysis, with a 95% confidence interval of 1.592 to 5.229, P=0.001. Conclusion There are significant differences in several clinical characteristics between patients with and without cerebral arterial vascular wall calcification in CAS, and the presence of vascular wall calcification accelerates disease progression and increases the risk of cerebrovascular events, which should be treated early and reasonably.

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更新日期/Last Update: 2023-06-20