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颈动脉周围脂肪密度与颈动脉狭窄以及预后的关系

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[目的]探讨颈动脉周围脂肪密度与颈动脉狭窄以及预后的关系.[方法]回顾性连续纳入209例2017年1月-2021年1月在台州市中心医院(台州学院附属医院)收治的颈内动脉颅外段狭窄的患者.通过颈动脉计算机断层成像血管造影评估最狭窄颈动脉轴层以及对侧同一轴层的血管周围脂肪密度;收集患者临床资料;根据指南对狭窄程度进行分度;回顾病史明确是否为症状性颈动脉狭窄;对患者进行1年的随访.[结果]患者颈动脉狭窄侧的周围脂肪密度比狭窄对侧高4.2%(P<0.001),且颈动脉周围脂肪密度随狭窄严重程度加重而增加.在狭窄侧,有症状组患者颈动脉周围脂肪密度比无症状组高6.25%(P=0.015).在无症状患者中,1年内发生狭窄侧相关脑血管结局事件组颈动脉周围脂肪密度比未发生患者组高12.4%(P=0.017),Logistic回归分析校正两组差异因素结果仍具有统计学差异(OR=1.060,95%CI:1.006~1.117,P=0.028).[结论]颈动脉周围脂肪密度与颈动脉狭窄程度呈正相关;症状性颈动脉狭窄以及再发狭窄侧相关缺血性脑血管结局事件患者的颈动脉周围脂肪密度高.
Association between carotid artery perivascular fat density and carotid artery steno-sis,prognosis
Aim To investigate the relationship between carotid artery perivascular fat density and carotid artery stenosis,prognosis.Methods A total of 209 consecutive patients with extracranial internal carotid artery stenosis in Taizhou Central Hospital(Taizhou University Affiliated Hospital)were retrospectively included from January 2017 to Janu-ary 2021.The carotid artery perivascular fat density in the narrowest axial layer and in the same contralateral axial layer was evaluated by computed tomography angiography.Clinical data of patients were collected.The stenosis was graded according to the guidelines.Symptomatic carotid stenosis was determined according to the medical history.The patients were followed up for one year.Results Carotid artery perivascular fat density was 4.2%higher on the stenosis side than those on the opposite side(P<0.001).The fat density increased with the stenosis severity.On the stenosis side,carotid artery perivascular fat density was 6.25%higher in symptomatic patients than that in asymptomatic patients(P=0.015).In asymptomatic patients,perivascular fat density in patients with stenosis related cerebrovascular events oc-curred within 1 year was 12.4%higher than that in patients without related cerebrovascular events(P=O.017),and the difference remained after adjusting the clinical parameters by Logistic regression analysis(OR=1.060,95%CI:1.006~1.117,P=0.028).Conclusions Carotid artery perivascular fat density is positively correlated with the degree of ca-rotid stenosis.Patients with symptomatic carotid artery stenosis or recurrent related ischemic cerebrovascular outcome e-vents have higher carotid artery perivascular fat density.

carotid artery stenosiscarotid perivascular fat densitystroke

毛玲群、何欣威、瞿曼、陈秋月

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台州市中心医院(台州学院附属医院)神经内科,浙江省台州市 318000

颈动脉狭窄 颈动脉周围脂肪密度 脑卒中

国家自然科学基金

82201479

2024

中国动脉硬化杂志
中国病理生理学会 南华大学

中国动脉硬化杂志

CSTPCD
影响因子:1.086
ISSN:1007-3949
年,卷(期):2024.32(3)
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