The impact of diabetes on the extent of pial collaterals in acute ischemic stroke patients
The impact of diabetes on the extent of pial collaterals in acute ischemic stroke patients
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DOI：
10.1136/jnis.2010.004507
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发表时间：
2011-09-01
影响因子：
4.8
通讯作者：
Mohammad, Yousef
中科院分区：
文献类型：
--
作者：
Lazzaro, Marc A.;Chen, Michael;Mohammad, Yousef
缺血性卒中中受威胁的血管区域由软脑膜侧支循环维持。糖尿病患者不同器官系统的新生血管情况不同。糖尿病对软脑膜侧支的影响尚不清楚。软脑膜侧支供应糖尿病和非糖尿病患者急性缺血性stroke. Materials and Methods数据库从两个机构进行了访问，以确定所有患者谁提出了急性大脑中动脉闭塞，并进行了紧急脑血管造影。使用先前发表的软脑膜侧支分级系统对血管造影片进行审查和分级。侧支循环分级系统分为良好（软脑膜1-2级）和差（软脑膜3-5级）。结果共确诊104例患者，男性56例（54%），平均年龄63.5岁，糖尿病患者22例（21%）。平均入院国立卫生研究院卒中量表为15.7。在糖尿病人群中，15例（68.2%）患者软脑膜侧支循环良好，7例（31.8%）患者软脑膜侧支循环不良。在非糖尿病人群中，59例（71.9%）患者软脑膜侧支循环良好，23例（28.0%）患者软脑膜侧支循环不良。糖尿病与软脑膜侧支循环分级无相关性（p=0.7290，Pearson χ 2）。结论糖尿病与缺血性脑卒中患者软脑膜侧支循环的程度无相关性。需要进一步研究以了解急性缺血性卒中患者软脑膜侧支循环模式及其对临床结局的影响。
Introduction The threatened vascular territory in ischemic stroke is maintained by pial collateral circulation. Neovascularization varies among organ systems in diabetic patients. The effect of diabetes on the extent of pial collaterals is not well known. The pial collateral supply was compared among diabetic and non-diabetic patients presenting with acute ischemic stroke.Material and methods Databases from two institutions were accessed to identify all patients who presented with acute middle cerebral artery occlusion and underwent emergent cerebral angiography. Angiograms were reviewed and graded using a previously published pial collateral grading system. The collateral grading system was dichotomized into good (pial grades 1-2) and poor (pial grades 3-5). A chi(2) analysis was performed to compare the association between diabetes and pial collateral grade.Results 104 patients were identified; 56 (54%) patients were men, mean age was 63.5 years and 22 (21%) patients had diabetes. Mean admission National Institutes of Health Stroke Scale was 15.7. In the diabetic population, 15 (68.2%) patients had good pial collaterals while seven (31.8%) patients had poor pial collaterals. In the non-diabetic population, 59 (71.9%) patients had good pial collaterals while 23 (28.0%) patients had poor pial collaterals. There was no association between diabetes and pial collateral grade (p=0.7290, Pearson chi(2)).Conclusions This series suggests there is no association between diabetes and the extent of pial collaterals in ischemic stroke patients. Further studies are warranted to understand pial collateral patterns in acute ischemic stroke patients and their impact on clinical outcomes.