颈内动脉颅内段钙化对轻型缺血性脑卒中患者预后的影响

Effect of intracranial internal carotid artery calcification on prognosis of patients with mild ischemic stroke

  • 摘要:
      目的  依据头颅计算机断层扫描(CT)和CT灌注成像(CTP)评估颈内动脉颅内段钙化(I-ICAC)程度,探讨其与轻型缺血性脑卒中(MIS)患者转归的相关性。
      方法  回顾性分析MIS患者228例,获得根据CT和CTP结果评估的I-ICAC分值,并将患者分成I-ICAC轻症组152例和I-ICAC重症组76例。观察2组90 d缺血性脑卒中复发情况; 观察2组90 d时美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin评分表(mRS)评分改善情况以及全因死亡率。
      结果  相较于I-ICAC轻症组,I-ICAC重症组的缺血性脑卒中复发率升高, NIHSS评分改善率降低,差异有统计学意义(P < 0.05); 2组患者90 d mRS评分改善率及全因死亡率比较,差异无统计学意义(P>0.05)。
      结论  I-ICAC重症患者缺血性脑卒中复发风险更高,应重视对MIS患者的I-ICAC评估。

     

    Abstract:
      Objective  To evaluate the degree of intracranial internal carotid artery calcifications (I-ICAC) according to the computed tomography (CT) and CT perfusion imaging (CTP), and to explore the correlation between degree of I-ICAC and prognosis in patients with mild ischemic stroke (MIS).
      Methods  A retrospective analysis was performed for 228 MIS patients, and they were divided into mild I-ICAC group (n=152) and severe I-ICAC group (n=76) according to I-ICAC scores evaluated on the basis of CT and CTP results. The 90-day recurrence of ischemic stroke of two groups was observed, and the improvement conditions of 90-day National Institutes of Health Stroke Scale (NIHSS) score, 90-day modified Ranking Scale (mRS) score and all-cause mortality were observed as well.
      Results  Compared with the mild I-ICAC group, the recurrence rate of ischemic stroke in the severe I-ICAC group was significantly higher, and the ratio of cases with improvement rate of NIHSS score was significantly lower (P < 0.05). There were no significant differences in the ratio of cases with improvement rate of 90-day mRS score and all-cause mortality between the two groups (P>0.05).
      Conclusion  Patients with severe I-ICAC have higher risk of ischemic stroke recurrence, so we should pay more attention to the I-ICAC evaluation of patients with MIS.

     

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