90岁以上高龄缺血性脑卒中患者颅内外动脉硬化研究.doc

90岁以上高龄缺血性脑卒中患者颅内外动脉硬化研究 王峻峰1，郁 可1，钟婷婷1，周华东1 ，彭艳2（第三军医大学大坪医院野战外科研究所神经内科1，第三军医大学大坪医院野战外科研究所肾内科2，重庆 400042） [摘要] 目的 探讨90岁以上高龄缺血性脑卒中患者颅内外动脉硬化的分布特点以及相关危险因素。方法 连续回顾2009年7月-2014年7月在第三军大学大坪医院住院诊断为缺血性卒中且已行头颈部CTA检查的患者。年龄≥90岁的92例设为研究组；年龄≤90岁的患者用系统抽样法随机编码，等距抽选110例设为对照组，比较两组CTA影像形态学特点及差异，分析两组患者既往病史、体重指数、血压、血糖、尿酸、血脂、胱抑素等危险因素与颅内外动脉硬化发生的关系。结果 研究组的颅内外动脉狭窄、斑块及各型迂曲发生率均显著高于对照组（P均＜0.01）。研究组中既往有高血压病、冠心病病史者多于对照组（P均0.05），收缩压、舒张压及胱抑素水平也高于对照组（P0.05）。而对照组中有吸烟、饮酒嗜好者明显较多（P均0.01），且体重指数、甘油三酯及低密度脂蛋白水平高于研究组（P均0.05）。结论 90岁以上高龄缺血性脑卒中患者的颅内外动脉硬化严重程度及发生率均明显增加。积极控制高血压、冠心病，监测胱抑素水平对于预防90岁以上高龄患者缺血性脑卒中的发生与再发有着重要意义。 [关键词] 90岁以上；颅内外动脉硬化；危险因素；CT血管造影 Characteristics of the cerebral arteriosclerosis in ischemic stroke patients aged 90 years and older Wang Junfeng1, Yu Ke1,ZhongTingting1, Zhou Huadong1,Peng Yan2 (Department of Neurology, Research Institute of Surgery Research, Daping Hospital, Third Military Medical University1, Department of Nephrology, Research Institute of Surgery Research, Daping Hospital, Third Military Medical University2,Chongqing, 400042, China) Abstract：Objective To investigate the characteristics and risk factors of the cerebral rteriosclerosis in ischemic stroke patients aged 90 years and older. Methods Patients who had been diagnosed with ischemic stroke and scanned by CTA admitted to the Department of Neurology in our hospital from November 1, 2013 to January 30, 2014, were consecutively enrolled in this study. The subjects were divide into study group (≥90 years, n=92) and matched group (≤90 years, n=110). Compare to the characteristics and differences between the two groups, the association between cerebral arteriosclerosis and medical history, body mass index (BMI), blood pressure, blood glucose, blood lipid, uric acid and cystatin were analyzed simultaneously. Results The frequency of atherosclerotic stenosis and tortuosity in study group was higher than the frequency in matched group (P＜0.01). The prevalence of history of hypertension and coronary disease in study group w