الملخص
Objective To investigate the predictive value of Essen stroke risk scale (ESRS) scores in stenosis of patients with anterior circulation acute ischemic stroke.Methods A total of 98 patients with atherosclerotic stroke in anterior circulation,admitted to our hospital from June 2011 to June 2013,were selected and performed head+neck CTA inspection cycle and ESRS.According to the ESRS scores,the patients were divided into low risk group (n=35),high risk group (n=44) and extremely high risk group (n=19).The relationship between the cerebrovascular morphology characteristics and ESRS scores were analyzed,and the predictive value of ESRS scores in stenosis was analyzed.Results (1) The distributions of these stenosis (the intracranial segment,the extracranial segment and combined intracranial and extracranial segments) were not significantly different among the three groups (P＞0.05).(2) Following the increase of ESRS scores,the degrees of luminal stenosis showed an increased trend in both circulation symptom side and non-symptom side (x2=9.784,P=0.002;xx2=9.215,P=0.002).(3) When the ESRS scores were higher than or equal to 3 points,the sensitivity of predicting mild stenosis was 63.6％,specificity 53.4％,with area under receiver operating characteristic curve (AUC) of 0.595 (P=0.182,95％CI:0.445-0.764);the sensitivity of predicting moderate stenosis,severe stenosis and occlusion was 60.3％,specificity 66.7％,with AUC of 0.679 (P=0.005,95％CI:0.553-0.805).Conclusions ESRS scores can predict the severity of the stenosis in patients with atherosclerotic cerebral stroke of anterior circulation.The patients having ESRS ≥ 3 scores should accept cerebrovascular examination to provide a certain basis for early and effective stratified intervention.
الملخص
Objective To explore the effect of vertebral artery dominance on basilar artery morphology and vascular vertigo,and understand the possible mechanisms.Methods Fifty-seven patients with vascular vertigo,admitted to our hospital from June 2011 to May 2013,were selected in our study; according to the head CTA vascular imaging,they were divided into vertebral artery dominance group (n=28) and vertebral artery non-dominance group (n=29).The clinical information and vertigo degrees from all of the patients were collected to analyze the vertebral-basilar artery and its relationship with vascular vertigo.Results In 28 patients with vertebral artery dominance,the left side of the dominance was noted in 21 patients (75％) and the right side of the dominance in 7 (25％),with statistically significant difference (x2=8.361,P=0.001); statistical significance of curve rate on both sides of the basal artery morphology was noted (x2=7.729,P=0.006).Most of its characteristic dominance of vertebral artery was C type,and the minority was S type and non-C type.The rate of basal artery bent in the dominant group was significantly higher than that in the non-dominant group (85.71％ and 31.03％,x2=18.196,P=0.000).The diameter (4.68±0.57 mm) and basal artery tortuosity (3.50+0.93 mm) in the dominant group were significantly larger than those in the non-dominant group (4.11 ±0.37 and 1.72±0.57,t=6.289,P=0.015; t=4.621,P=0.036).The theory length of basal artery showed no statistical significance between the two groups (P＞0.05).The greater the differences of both sides of the vertebral artery diameter,and the more obvious the basal diameter and basal artery tortuosity (P＜0.05).The level of vertigo in the non-dominant group was significantly higher than that in the dominant group (t=4.386,P=0.041).Vertigo severity level was positively associated with basal artery tortuosity and vertebral artery diameter (r=0.328,P=0.013; r=0.458,P=0.002).Conclusions There is higher rate of bending degree level and dizziness in patients of dominance of vertebral artery.Vertebral artery dominance is associated with vascular vertigo.
الملخص
Objective To investigate the relationship between carotid artery calcification and ischemic stroke.Methods The demographic data,vascular risk factors and clinical features of patients with acute ischemic stroke and non-acute stroke patients admitted in the same period were collected retrospectively.All the patients received 64-slice spiral CT examination,and the scan data were transmitted to a GE workstation.A smart score software was used to evaluate carotid artery calcification.Multivariate logistic regression analysis was used to identify the independent risk factors for ischemic stroke.Receiver operator characteristic (ROC) curve was used to analyze and determine the predictive value of carotid artery calcification in acute ischemic stroke.Results A total of 86 patients with acute ischemic stroke and 89 with non-acute stroke (control group) were enrolled.In addition to the previous stroke history,there were no significant differences in age,gender,and vascular risk factors between the ischemic stroke group and the control group.The calcium score (338.57 ± 77.35 vs.147.79 ± 64.52; t =4.065,P =0.045),total calcified volume (372.22 ± 78.73 mm3 vs.197.27 ±61.12 mm3; t =4.740,P =0.031),and calcification quality (70.33 ± 13.83 mg vs.32.44 ± 12.27 mg; t =6.673,P =0.011) of the ischemic stroke group were significantly higher than those of the control group.In patients with ischemic stroke,there were no significant differences in the carotid artery calcification score (335.50 ± 85.95 vs.312.73 ± 90.61; t =0.052,P =0.820),total calcified volume (357.91 ± 88.93 mm3 vs.311.71 ± 81.43 mm3; t=0.071,P=0.791),and calcium quality (59.68± 17.36 mg vs.51.29 ± 18.69 mg; t =0.071,P =0.791) between the symptomatic sides and non-symptomatic sides.Multivariate logistic regression analysis showed that the carotid artery calcification score (odds ratio [OR] 4.963,95％ confidence interval [CI] 5.932-18.994; P=0.019),total calcified volume (OR 5.967,95％ CI 3.940-14.993; P =0.015),and calcium quality (OR 6.815,95％ CI 4.703-21.946; P =0.007) were the independent risk factors for ischemic stroke.The ROC curve analysis of carotid artery calcification score showed that when it was 231.25,it had a predictive value for acute ischemic stroke.The sensitivity was 85.4％,specificity was 89.9％,positive predictive value was 87.1％,and negative predictive value was 89.1％.The area under the ROC curve was 0.891 (95％ CI 0.808-0.913; P =0.027).Conclusions Carotid artery calcification is one of the independent risk factors for ischemic stroke.Carotid artery calcification score has some predictive value for acute ischemic stroke.