Small-vessel occlusion versus large-artery atherosclerotic strokes in diabetics: Patient characteristics, outcomes, and predictors of stroke mechanism
Small-vessel occlusion versus large-artery atherosclerotic strokes in diabetics: Patient characteristics, outcomes, and predictors of stroke mechanism
复制标题
DOI：
10.1177/2396987316647856
复制
发表时间：
2016-06-01
影响因子：
6.1
通讯作者：
Papavasileiou, V.
中科院分区：
文献类型：
--
作者：
Ntaios, G.;Milionis, H.;Papavasileiou, V.
简介： 糖尿病对脑血管系统产生有害影响，影响大血管系统和微血管系统。然而，尽管缺血性中风通常包含在大血管糖尿病并发症中，但它经常被忽略在微血管糖尿病并发症中。我们的目的是比较糖尿病卒中患者中大动脉粥样硬化性卒中和小血管闭塞性卒中的比例，探讨它们的差异和结果，并评估可能决定为什么一些糖尿病患者患有大动脉粥样硬化性卒中而其他患者患有小血管闭塞性卒中的潜在机制。 方法：我们汇集了来自四个前瞻性缺血性卒中登记处（洛桑急性卒中登记和分析（ASTRAL），雅典，奥地利，和赫尔辛基中风溶栓登记处）。分别使用美国国立卫生研究院卒中量表 (NIHSS) 和 ASTRAL 评分评估卒中严重程度和预后；三个月修正Rankin评分的功能结果（0-2被认为是有利的结果）。 Logistic 回归分析确定了大动脉粥样硬化性中风的独立预测因素。结果：在 5412 名患者中，1069 名 (19.8%) 是糖尿病患者；其中，232 例（21.7%）患有大动脉粥样硬化，205 例（19.2%）患有小血管闭塞中风。大动脉粥样硬化性卒中的严重程度高于小血管闭塞性卒中（NIHSS 中位数：6 vs. 3，p
Introduction: Diabetes mellitus exerts a detrimental effect on cerebral vasculature affecting both macrovasculature and microvasculature. However, although ischaemic stroke is typically included among macrovascular diabetic complications, it is frequently omitted from microvascular diabetic complications. We aimed to compare the proportion of large-artery atherosclerotic and small-vessel occlusion strokes among diabetic stroke patients, explore their differences and outcomes, and assess potential mechanisms which may determine why some diabetic patients suffer large-artery atherosclerotic stroke whereas others suffer small-vessel occlusion stroke.Methods: We pooled data of diabetic patients from four prospective ischaemic stroke registries (Acute Stroke Registry and Analysis of Lausanne (ASTRAL), Athens, Austrian, and Helsinki Stroke Thrombolysis Registries). Stroke severity and prognosis were assessed with National Institutes of Health Stroke Scale (NIHSS) and ASTRAL scores, respectively; functional outcome with three-month modified Rankin score (0-2 considered as favourable outcome). Logistic-regression analysis identified independent predictors of large-artery atherosclerotic stroke.Results: Among 5412 patients, 1069 (19.8%) were diabetics; of them, 232 (21.7%) had large-artery atherosclerotic and 205 (19.2%) small-vessel occlusion strokes. Large-artery atherosclerotic stroke had higher severity than small-vessel occlusion stroke (median NIHSS: 6 vs. 3, p