Carotid artery intima-media thickness and lacunar versus nonlacunar Infarcts
Carotid artery intima-media thickness and lacunar versus nonlacunar Infarcts
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DOI：
10.1161/hs0302.103661
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发表时间：
2002-03-01
期刊：
影响因子：
8.3
通讯作者：
Bernardi, G
中科院分区：
文献类型：
--
作者：
Cupini, LM;Pasqualetti, P;Bernardi, G
背景和目的--在没有心血管疾病病史的受试者中，颈动脉内膜和中层厚度的增加与心肌梗死和中风的风险增加有关。腔隙性脑梗塞是缺血性卒中最常见的亚型之一，具有独特的病理和临床放射学特征。本研究探讨血管危险因素，包括颈动脉内中膜厚度(IMT)与腔隙性与非腔隙性脑梗塞之间的关系。对患者和129例对照组进行了颈总动脉内中膜厚度的B型超声测量。我们调查了腔隙性和非腔隙性脑梗塞与年龄、性别和潜在的血管危险因素的关系。结果：292例首次急性缺血性卒中的成人患者。96例被认为是腔隙性中风，196例被认为是非腔隙性中风。我们没有发现糖尿病、吸烟、高血压、血脂异常、心肌梗死和既往短暂性脑缺血发作在两组患者中的比例有显著差异。多项Logistic回归分析选择颈动脉内中膜厚度和房颤作为区分腔隙和非腔隙患者的唯一独立因素。非腔隙性卒中患者的IMT值明显高于腔隙性卒中患者和对照组。结论--本研究结果表明超声无创性测量IMT可作为一种诊断工具，有助于识别不同亚型的缺血性卒中患者。无创性测量可能对腔隙性脑梗塞与非腔隙性脑梗塞有预测作用。
Background and Purpose-Increases in the thickness of the intima and media of the carotid artery have been associated with an increased risk of myocardial infarction and stroke in subjects without a history of cardiovascular disease. Lacunar infarcts, one of the most common subtype of ischemic stroke, show unique pathological and clinicoradiological characteristics. The present study examines the relationship between vascular risk factors, including carotid artery intima-media thickness (IMT), and lacunar versus nonlacunar infarcts.Methods-We collected data from patients with acute ischemic stroke admitted to hospital. Patients and 129 control subjects underwent B-mode ultrasonographic measurements of IMT of the common carotid artery. We examined the association of lacunar and nonlacunar infarcts with age, sex, and potential vascular risk factors.Results-Of 292 adult patients with an acute first-ever ischemic stroke. 96 were considered lacunar and 196 were considered nonlacunar strokes. We did not find a significantly different percentage of diabetes, smoking, hypertension, dyslipidemia, myocardial infarction, and previous transient ischemic attack between the 2 groups of patients. The multinomial logistic regression procedure selected carotid artery IMT and atrial fibrillation as the only independent factors able to discriminate between lacunar and nonlacunar patients. IMT values were significantly higher in patients with nonlacunar stroke versus both those with lacunar stroke and control subjects.Conclusions-The present results indicate the usefulness of noninvasive measurement of IMT with ultrasonic techniques as a diagnostic tool that may help to identify different subtypes of ischemic stroke patients. The noninvasive measurements may have predictive power with respect to lacunar versus nonlacunar infarcts.