發(fā)布時(shí)間：2018-07-17 03:49

【摘要】：目的探討影像學(xué)特征對(duì)癥狀性動(dòng)脈粥樣硬化性顱內(nèi)動(dòng)脈狹窄患者內(nèi)科治療效果的預(yù)測(cè)價(jià)值。方法在2015年1月-2016年6月選取我院接受規(guī)范化住院治療的癥狀性動(dòng)脈粥樣硬化性顱內(nèi)動(dòng)脈狹窄患者136例,全部是首次以急性腦梗死入院治療的患者,其中男性75例,女性61例,平均年齡58.57±8.32歲。根據(jù)發(fā)病后6h-1周美國(guó)國(guó)立衛(wèi)生研究院卒中量表(National institutes of health stroke,NIHSS)評(píng)分將患者分為進(jìn)展性卒中組29例和非進(jìn)展組107例。收集患者臨床基本資料及實(shí)驗(yàn)室化驗(yàn)、影像學(xué)檢查資料,并比較兩組的差異,對(duì)有統(tǒng)計(jì)學(xué)意義的單因素作為自變量進(jìn)行多因素Logistic回歸分析,多因素logistic回歸分析s ICAS患者的影像學(xué)特征與其內(nèi)科治療效果的相關(guān)性。結(jié)果136例癥狀性動(dòng)脈粥樣硬化性顱內(nèi)動(dòng)脈狹窄患者中進(jìn)展組29例,非進(jìn)展組107例,單因素分析顯示進(jìn)展組中糖化白蛋白水平(P=0.016)、低密度脂蛋白水平(P=0.032)、同型半胱氨酸水平(P=0.047)、腦微出血比例(P=0.038)、顱內(nèi)責(zé)任血管狹窄程度(重度或閉塞)比例(P=0.010)均明顯高于非進(jìn)展組。多因素logistic回歸分析表明,糖化白蛋白(OR=1.214,95%CI:1.071-1.376,P=0.002)及責(zé)任血管狹窄程度(OR=3.044,95%CI:1.127-8.227,P=0.023)是s ICAS內(nèi)科治療效果較差的獨(dú)立預(yù)測(cè)因素。結(jié)論:s ICAS患者的影像學(xué)特征與其內(nèi)科治療效果存在相關(guān)性,顱內(nèi)動(dòng)脈重度狹窄或閉塞和糖化白蛋白水平是s ICAS內(nèi)科治療效果較差的重要預(yù)測(cè)因素。
[Abstract]:Objective to evaluate the predictive value of imaging features in patients with symptomatic atherosclerotic intracranial artery stenosis. Methods from January 2015 to June 2016, 136 patients with symptomatic atherosclerotic intracranial artery stenosis who received standardized hospitalization in our hospital were selected, all of whom were hospitalized for the first time with acute cerebral infarction (75 males and 61 females). The average age was 58.57 鹵8.32 years old. The patients were divided into progressive stroke group (29 cases) and non-progressive group (107 cases) according to the National institutes of health Stroke scale (NIHSS) score of 6h-1 week after onset. The basic clinical data, laboratory tests and imaging data were collected, and the differences between the two groups were compared. Multivariate logistic regression analysis was used to analyze the statistical significance of single factor as independent variable. Multivariate logistic regression analysis was used to analyze the correlation between the imaging features of sICAS patients and the effect of medical treatment. Results among 136 patients with symptomatic atherosclerotic intracranial stenosis, 29 were in progressive group and 107 in non-progressive group. Univariate analysis showed that the levels of glycosylated albumin (Pn0. 016), low density lipoprotein (P0. 032), homocysteine (P0. 047), cerebral microhemorrhage (P0. 038) and the degree of intracranial responsible vascular stenosis (P0. 010) in the progressive group were significantly higher than those in the non-progressive group. Multivariate logistic regression analysis showed that the degree of glycosylated albumin (OR 1.214C95CI: 1.071-1.376P0. 002) and the degree of responsible vascular stenosis (OR 3.04495) were independent predictors of the poor efficacy of SICAS. Conclusion the imaging features of the patients with SICAS are correlated with the effect of internal medicine treatment. The severe stenosis or occlusion of intracranial artery and the level of glycosylated albumin are the important predictors of the poor efficacy of the internal medicine treatment of SICAS.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 韓忠奎;任明山;夏元亮;鎖六軍;;首發(fā)急性腔隙性腦梗死患者腦微出血與早期神經(jīng)功能惡化的關(guān)聯(lián)研究[J];醫(yī)學(xué)研究生學(xué)報(bào);2015年11期

2 劉新峰;朱武生;孫文;徐格林;;中國(guó)缺血性腦血管病血管內(nèi)介入診療指南2015[J];中華神經(jīng)科雜志;2015年10期

3 王擁軍;王春雪;繆中榮;;中國(guó)缺血性腦卒中和短暫性腦缺血發(fā)作二級(jí)預(yù)防指南2014[J];中華神經(jīng)科雜志;2015年04期

4 馮海松;黎紅華;;顱內(nèi)外動(dòng)脈粥樣硬化機(jī)制差異的研究進(jìn)展[J];中西醫(yī)結(jié)合心腦血管病雜志;2012年09期

5 董強(qiáng);黃家星;黃一寧;徐安定;曾進(jìn)勝;陳向燕;程忻;范玉華;劉亞杰;孫葳;譚澤峰;徐蔚海;;癥狀性動(dòng)脈粥樣硬化性顱內(nèi)動(dòng)脈狹窄中國(guó)專家共識(shí)[J];中國(guó)神經(jīng)精神疾病雜志;2012年03期

6 張曉暉;張寶利;王小沙;童晨光;祁江峽;郭海燕;胡洋;;腦動(dòng)脈狹窄分布特征及其危險(xiǎn)因素的分析[J];中國(guó)腦血管病雜志;2010年09期

7 宋桂芹;王擁軍;董可輝;姜衛(wèi)劍;杜斌;陳啟東;;缺血性腦血管病患者腦動(dòng)脈狹窄的分布[J];中華老年心腦血管病雜志;2008年09期

8 史懷璋,李斗,李慎茂,凌鋒;經(jīng)DSA分析1000例缺血性腦血管病華人患者的病因特點(diǎn)[J];中國(guó)腦血管病雜志;2005年10期

9 周衡,王擁軍,王素香,趙性泉;急性缺血性腦卒中的TOAST亞型分析[J];中華內(nèi)科雜志;2004年07期

10 劉芳齡,張葆樽,田玉旺;腦卒中患者顱內(nèi)外動(dòng)脈形態(tài)變化分析[J];中華醫(yī)學(xué)雜志;1996年11期

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