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首页> 外文期刊>Journal of neurology >Clinical determinants of infarct pattern subtypes in large vessel atherosclerotic stroke.
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Clinical determinants of infarct pattern subtypes in large vessel atherosclerotic stroke.

机译：大血管粥样硬化性中风的梗死模式亚型的临床决定因素。

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BACKGROUND: Although stroke from large vessel atherothromboembolism has a common pathogenesis, its topographic presentation is variable. Given the impact of cerebral infarct size and location on incident stroke magnitude and subsequent prognosis, we evaluated the determinants of cerebral infarct topography among patients with atherosclerotic stroke. METHODS: We analyzed data on 148 consecutive patients admitted over a 4-year period to a university medical center with acute ischemic stroke within the MCA distribution on DWI, presumed due to atherosclerosis. Based on the DWI data, we divided the patients into three stroke phenotypes: large cortical, small (< 1 cm in diameter) cortical, and deep pattern. Independent factors for each stroke phenotype were evaluated using logistic regression. RESULTS: After adjusting for covariates, premorbid statin use (OR, 3.05; 95% CI, 1.40-6.65) and older age (OR, 1.05 per 1 year increase; 95% CI, 1.02-1.08) were independently associated with the small cortical phenotypic pattern. In contrast, younger age (OR, 0.95 per 1 year increase; 95% CI, 0.92-0.98), premorbid statin non-use (OR, 0.40; 95% CI, 0.17-0.99), and higher levels of fasting s-glucose (OR, 1.01 per 1 mg/dl increase; 95% CI, 1.00-1.02) and admission peripheral WBC counts (OR, 1.13 per 1 x 10(9) cells/L; 95% CI, 1.00-1.27) were independently associated with the large cortical pattern. There was no relation between DWI patterns and LDL-cholesterol levels. CONCLUSIONS: Age, premorbid statin use, s-glucose and WBC count predict atherosclerotic stroke phenotype. Further studies should examine whether modifying some of these factors may result in more favorable phenotypic patterns.
机译：背景：尽管大血管动脉粥样硬化血栓栓塞引起的中风具有常见的发病机制，但其地形表现却是可变的。考虑到脑梗塞的大小和位置对卒中的发生程度和随后的预后的影响，我们评估了动脉粥样硬化性卒中患者脑梗塞地形的决定因素。方法：我们分析了在4年内入院的148例连续患者的数据，这些患者是由动脉粥样硬化引起的DWI MCA分布范围内的急性缺血性中风。根据DWI数据，我们将患者分为三种卒中表型：大皮质，小（直径<1 cm）皮质和深型。使用logistic回归评估每种卒中表型的独立因素。结果：在校正协变量后，病态前他汀类药物的使用（OR，3.05; 95％CI，1.40-6.65）和老年（OR，每1年增加1.05; 95％CI，1.02-1.08）与小皮层独立相关表型模式。相反，年龄较小（OR，每1年增加0.95; 95％CI，0.92-0.98），病前未使用他汀类药物（OR，0.40; 95％CI，0.17-0.99）和较高的空腹s-葡萄糖水平（OR，每增加1 mg / dl 1.01; 95％CI，1.00-1.02）和入院外周血白细胞计数（OR，每1 x 10（9）细胞1.13 1.13; 95％CI，1.00-1.27）独立相关皮质大图案。 DWI模式与LDL-胆固醇水平之间没有关系。结论：年龄，病态前他汀类药物使用，s-葡萄糖和白细胞计数可预测动脉粥样硬化性卒中表型。进一步的研究应检查是否修改其中一些因素可能会导致更有利的表型模式。

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