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文摘
目的:近端主动脉粥样斑已经被认为是一个潜在的缺血性中风行列式在老年人,尤其是在不明原因的情况下(隐)中风。我们的目的是评估近端主动脉粥样斑的潜在作用作为一个独立的危险因素中风通过比较它们的频率在急性缺血性中风患者和stroke-free对照组。粥样斑的频率也是不同民族之间进行比较。患者和方法:病例对照研究106年急性缺血性中风患者和114年stroke-free对照组。的存在会导致主动脉近端部分的被双翼飞机多角度评估。会导致分类的基础上他们的厚度(0.2到0.4厘米,小;>或= to0.5厘米,大)和复杂性(即。、溃疡或移动)。主动脉粥样斑和缺血性中风之间的关系进行了测试,控制患者的人口统计学变量和中风危险因素。在中风患者,子群分析测试主动脉粥样斑之间的关联和中风诊断亚型(确定原因和不明原因引起的)和存在和颈动脉狭窄程度的双多普勒检查。结果:大主动脉粥样斑的频率比控制在中风患者(分别为26%和13%; crude odds ratio [OR] 2.4, 95% CI 1.2 to 4.7); ulcerated or mobile atheromas also tended to be more frequent in stroke patients (12% versus 5%; OR 2.5, 95% CI 1.0 to 6.8). Differences were entirely attributable to the subgroup of patients aged 60 years or older, in whom the frequency of ulcerated or mobile atheromas was particularly high among cryptogenic stroke patients (22% versus 8% in control subjects; OR 3.4, 95% CI 1.1 to 11.2). Multivariate analysis showed the presence of large atheromas to be independently associated with stroke in the entire study group (adjusted OR 2.6, 95% CI 1.1 to 5.9) and in the older subgroup (OR 2.4, 95% CI 1.1 to 5.7). Carotid stenosis >or=to 60% was more frequent with increasing size and complexity of aortic atheromas but had low predictive value (16%) for presence of large atheromas; moreover, 36% of patients with mild or no carotid stenosis had large or complex aortic atheromas. No significant differences were found in the frequency of atheromas by ethnic group. Conclusions: Proximal aortic atheromas >or=to 0.5 cm in size are a risk factor for ischemic stroke in patients aged 60 years or older. Ulcerated or mobile atheromas may play a role in explaining some cryptogenic strokes in the elderly. The risk for stroke of patients with aortic atheromas may be similar across different ethnic groups. The absence of carotid stenosis does not exclude aortic atheromas as a potential cause for ischemic stroke.
首页神经学1996;46:1560 - 1566
- 版权1996年Advanstar通信公司。
