[1]刘 宏,何明方.轻症脑卒中/短暂性脑缺血发作继发血管周围间隙扩大与视网膜血管损伤的相关性[J].医学信息,2023,36(15):120-123.[doi:10.3969/j.issn.1006-1959.2023.15.024]
 LIU Hong,HE Ming-fang.Correlation Between Enlarged Perivascular Space Secondary to Mild Stroke/Transient Ischemic Attack and Retinal Vascular Injury[J].Journal of Medical Information,2023,36(15):120-123.[doi:10.3969/j.issn.1006-1959.2023.15.024]
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轻症脑卒中/短暂性脑缺血发作继发血管周围间隙扩大与视网膜血管损伤的相关性()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年15期
页码:
120-123
栏目:
论著
出版日期:
2023-08-01

文章信息/Info

Title:
Correlation Between Enlarged Perivascular Space Secondary to Mild Stroke/Transient Ischemic Attack and Retinal Vascular Injury
文章编号:
1006-1959(2023)15-0120-04
作者:
刘 宏何明方
(广元市中心医院脑血管病科,四川 广元 628000)
Author(s):
LIU HongHE Ming-fang
(Department of Cerebrovascular Diseases,Guangyuan Central Hospital,Guangyuan 628000,Sichuan,China)
关键词:
轻症脑卒中短暂性脑缺血发作血管周围间隙扩大眼底血管病变
Keywords:
Mild strokeTransient ischemic attackEnlarged perivascular spaceFundus vasculopathy
分类号:
R743
DOI:
10.3969/j.issn.1006-1959.2023.15.024
文献标志码:
A
摘要:
目的 探讨轻症脑卒中/短暂性脑缺血发作(TIA)继发血管周围间隙扩大(EPVS)与视网膜血管损伤的相关性。方法 选取我院2017年1月-2021年6月收治的轻症脑卒中/TIA患者246例,根据有无EPVS分为EPVS组和无EPVS组,其中EPVS组104例,无EPVS组142例;比较两组性别、年龄、合并血管危险因素、实验室指标、影像学指标、NIHSS评分及ABCD3-Ⅰ评分,采用Logistic回归模型评价EPVS发生的独立危险因素,分析EPVS与眼底血管病变严重程度的相关性。结果 EPVS组年龄、高血压例数及眼动脉硬化分级评分均低于无EPVS组(P<0.05);EPVS组血管瘤和动静脉交叉征发生例数多于无EPVS组(P<0.05);EPVS组视网膜中央动脉直径和动静脉比值低于无EPVS组(P<0.05);多因素分析显示,高血压和眼动脉硬化是轻症脑卒中/TIA患者发生EPVS的独立危险因素;Spearman相关性分析显示,EPVS严重程度与眼底动脉硬化程度呈正相关(r=0.774);EPVS严重程度与视网膜中央动脉直径、动静脉比值呈负相关(r=-0.322、-0.451);多因素线性回归分析显示,EPVS数量与动静脉交叉征和眼底动脉硬化呈正相关(r=0.434、0.552),EPVS数量与动静脉比值呈负相关(r=-4.646)。结论 轻症脑卒中/TIA患者中合并高血压和眼动脉硬化人群更易发生EPVS,且EPVS严重程度和数量均与眼底血管病变有关。
Abstract:
Objective To investigate the correlation between enlarged perivascular space (EPVS) secondary to mild stroke/transient ischemic attack (TIA) and retinal vascular injury.Methods A total of 246 patients with mild stroke/TIA admitted to our hospital from January 2017 to June 2021 were selected and divided into EPVS group and non-EPVS group according to the presence or absence of EPVS, including 104 patients in EPVS group and 142 patients in non-EPVS group. The gender, age, combined vascular risk factors, laboratory indexes, imaging indexes, NIHSS score and ABCD3-I score were compared between the two groups. Logistic regression model was used to evaluate the independent risk factors of EPVS, and the correlation between EPVS and the severity of fundus vascular lesions was analyzed.Results The age, number of hypertension cases and ophthalmic arteriosclerosis grading score in the EPVS group were lower than those in the non-EPVS group (P<0.05). The cases of hemangioma and arteriovenous crossing sign in EPVS group were more than those in non-EPVS group (P<0.05). The central retinal artery diameter and arteriovenous ratio in the EPVS group were lower than those in the non-EPVS group (P<0.05). Multivariate analysis showed that hypertension and ophthalmic arteriosclerosis were independent risk factors for EPVS in patients with mild stroke/TIA. Spearman correlation analysis showed that the severity of EPVS was positively correlated with the degree of fundus arteriosclerosis (r=0.774). The severity of EPVS was negatively correlated with central retinal artery diameter and arteriovenous ratio (r=-0.322, -0.451). Multivariate linear regression analysis showed that the number of EPVS was positively correlated with arteriovenous crossing sign and fundus arteriosclerosis (r=0.434, 0.552), and the number of EPVS was negatively correlated with arteriovenous ratio (r=-4.646).Conclusion EPVS is more likely to occur in patients with mild stroke/TIA complicated with hypertension and ophthalmic arteriosclerosis, and the severity and number of EPVS are related to fundus vascular lesions.

参考文献/References:

[1]Nakada T,Kwee IL.Fluid dynamics inside the brain barrier: current concept of interstitial flow, glymphatic flow, and cerebrospinal fluid circulation in the brain[J].Neuroscientist,2019,25(2):155-166.[2]Wang W,Dong FM,Shao K,et al.The montreal cognitive assessment and mini-mental state examination visuoexecutive subtests in acute ischemic stroke patients and their correlations with demographic and clinical factors[J].Acta Neurol Belg,2020,21(11):814-822.[3]Lau KK,Li L,Lovelock CE,et al.Clinical correlates, ethnic differences, and prognostic implications of perivascular spaces in transient ischemic attack and ischemic stroke[J].Stroke,2017,48(6):1470-1477.[4]Makkinejad N,Tamhane AA,Leurgans SE,et al.Neuropathologic and Cognitive Correlates of Enlarged Perivascular Spaces in a Community-Based Cohort of Older Adults[J].Stroke,2020,51(9):2825-2833.[5]Arba F,Quinn TJ,Hankey GJ,et al.Enlarged perivascular spaces and cognitive impairment after stroke and transient ischemic attack[J].Int J Stroke,2018,13(1):47-56.[6]Wardlaw JM,Smith C,Dichgans M.Small vessel disease: mechanisms and clinical implications[J].Lancet Neurol,2019,18(7):684-696.[7]Cabrera DeBuc D,Somfai GM,Koller A.Retinal microvascular network alterations: potential biomarkers of cerebrovascular and neural diseases[J].Am J Physiol Heart Circ Physiol,2017,312(2):H201-H212.[8]Levine DA,Galecki A,Kabeto M,et al.Mild cognitive impairment and receipt of procedures for acute ischemic stroke in older adults[J].J Stroke Cerebrovasc Dis,2020,29(10):105083.[9]Qiu C,Ding J,Sigurdsson S,et al.Differential associations between retinal signs and CMBs by location: the AGES-Reykjavik study[J].Neurology,2018,90(2): e142-e148.[10]McGrory S,Ballerini L,Doubal FN,et al.Retinal microvasculature and cerebral small vessel disease in the Lothian Birth Cohort 1936 and Mild Stroke Study [J].Sci Rep,2019,9(1):6320-6327.[11]Brown R,Benveniste H,Black SE,et al.Understanding the role of the perivascular space in cerebral small vessel disease[J].Cardiovasc Res,2018,114(11):1462-1473.[12]Li Y,Li M,Yang L,et al.The relationship between blood-brain barrier permeability and enlarged perivascular spaces: a cross-sectional study[J].Clin Interv Aging,2019,14(6):871-878.[13]Lavin P,Patrylo M,Hollar M,et al.Stroke risk and risk factors in patients with central retinal artery occlusion[J].Am J Ophthalmol,2018,196(10):96-100.[14]McHutchison CA,Chappell FM,Makin S,et al.Stability of Estimated Premorbid Cognitive Ability over Time after Minor Stroke and Its Relationship with Post-Stroke Cognitive Ability[J].Brain Sci,2019,9(5):117-122.[15]Wardlaw JM,Benveniste H,Nedergaard M,et al.Perivascular spaces in the brain: anatomy, physiology and pathology[J].Nat Rev Neurol,2020,16(3):137-153.[16]Chodnicki KD,Pulido JS,Hodge DO,et al.Stroke risk before and after central retinal artery occlusion in a US cohort[J].Mayo Clin Proc,2019,94(2):236-241.[17]Pedragosa J,Salas-Perdomo A,Gallizioli M,et al.CNS-border associated macrophages respond to acute ischemic stroke attracting granulocytes and promoting vascular leakage[J].Acta Neuropathol Commun,2018,6(1):76-83.[18]Huang X,Yang Q,Shi X,et al.Predictors of malignant brain edema after mechanical thrombectomy for acute ischemic stroke[J].J Neurointerv Surg,2019,11(10):994-998.

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更新日期/Last Update: 1900-01-01