Stroke:检测斑块类型,识别高风险卒中患者

2015-10-21 phylis 译 MedSci原创

背景和目的:这篇研究的目的是为了分析人类颈动脉斑块的形态和患者性别,年龄以及神经系统症状史的相关性。方法:这篇研究包括2004年到2013年间,763名存在粥样硬化患者颈动脉狭窄术后取下的斑块。颈动脉斑块的形态学分析评估斑块的类型,斑块的稳定性,钙化的程度,炎症以及血管再生和胶原蛋白和弹性蛋白的沉积。根据预后的评估,logistic回归,有序回归,多分类回归分析。校正常见粥样硬化的危险因素。结果:

背景和目的:这篇研究的目的是为了分析人类颈动脉斑块的形态和患者性别,年龄以及神经系统症状史的相关性。


方法:这篇研究包括2004年到2013年间,763名存在粥样硬化患者颈动脉狭窄术后取下的斑块。颈动脉斑块的形态学分析评估斑块的类型、斑块的稳定性、钙化的程度、炎症以及血管再生和胶原蛋白及弹性蛋白的沉积。根据预后的评估、logistic回归、有序回归、多分类回归分析。校正常见粥样硬化的危险因素。

结果:男性患者斑块细胞较多(OR, 1.56),炎症浸润严重(OR, 1.75),新生血管较多(OR, 1.47),但血管钙化较少(OR, 0.78)。有症状的患者,弹性蛋白量较低(OR, 0.71)。高龄与钙化增加相关(OR, 1.23)。有症状的患者常见不稳定斑块(OR, 1.60; 95% CI, 1.14-2.25)。多分类回归分析显示年龄,性别和神经系统症状与特异性斑块类型相关。

结论:男女患者斑块形态不同,并且随年龄而改变。某种类型的斑块(VI及VI/VII)及不稳定斑块与神经系统症状显著相关。因此,尤其是基于性别和年龄的个体化检测(比如:斑块出血或薄纤维帽的检测)应该可以识别卒中高风险患者。

原文出处:

Wendorff C, Wendorff H, Pelisek J,et al.Carotid Plaque Morphology Is Significantly Associated With Sex, Age, and History of Neurological Symptoms. Stroke. 2015, Oct 8.

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