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Stroke:颈动脉内膜厚度增加,首次卒中风险更大

2020-02-13 国际循环 网络

近期,Stroke杂志刊登了来自北京大学第一医院霍勇教授团队的研究成果,该研究旨在探讨高血压患者平均颈动脉内膜中层厚度(cIMT)与首次卒中风险之间的关系,并探讨任何潜在影响因素。

颈动脉内膜增厚是由动脉粥样硬化引起的血管壁增增生,主要后果是脑供血不足和脑血管病的发生。近期,Stroke杂志刊登了来自北京大学第一医院霍勇教授团队的研究成果,该研究旨在探讨高血压患者平均颈动脉内膜中层厚度(cIMT)与首次卒中风险之间的关系,并探讨任何潜在影响因素。
 
共有11 547例无卒中史的高血压患者参加这项中国卒中一级预防试验,试验设定主要终点是首次卒中发作。在4.4年的中位随访中,共出现726例首次卒中发作病例,其中631例为缺血性卒中,90例为出血性卒中。平均cIMT每增加一个SD,患者首次卒中发作(HR=1.11;95%CI: 1.03~1.20)和首次缺血性卒中发作(HR=1.10;95%CI: 1.01~1.20)的风险也相应增加,且呈正相关。此外,当cIMT被分为四分位时,与四分位1(<0.66 mm)的患者相比,四分位2~4(>0.66 mm)的患者首次卒中发作(HR=1.31;95%CI: 1.06~1.61)和首次出血性卒中发作(HR=2.25;95%CI: 1.11~4.58)的风险更高。更重要的是,在平均动脉压[≥109.3(五分位数5)vs <109.3 mm Hg,P相互作用=0.024]或舒张压水平[≥90.7(五分位数5)vs <90.7 mm Hg,P相互作用=0.009]较高的患者中,cIMT与首次卒中风险的相关性显著增强。
 
这项研究结果提示,在高血压患者中,基线cIMT与首次卒中风险存在显著的正相关。同时,平均动脉压或舒张压较高的人群中,这种相关性更强。

原文出处:
Michelle R. Caunca, Marialaura Simonetto, et al. Diastolic Blood Pressure Is Associated With Regional White Matter Lesion Load:The Northern Manhattan Study. Stroke. Originally published8 Jan 2020.

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    2020-02-13 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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    2020-02-13 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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