双侧大脑中动脉高密度征形成的相关因素分析

摘要

目的 探讨双侧大脑中动脉高密度征(double hyper dense middle cerebral artery sign,DHMCAS)形成的相关因素.方法 调阅本院2011年至2015年行头颅CT检查的住院患者共600例,将其中30例双侧大脑中动脉M1段享氏单位(Hounsfield unit,HU)值＞43,大脑中动脉与脑皮质密度比＞1.2者定义为DHMCAS组.选取同期住院患者30例作为对照组.分别收集2组患者的性别、年龄、高血压史、糖尿病史、吸烟史、饮酒史,短暂性脑缺血发作(transient ischemic attack,TIA)史以及红细胞比容(HCT)、血小板(PLT)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、纤维蛋白原(FIB)、血游离脂肪酸(FFA)、载脂蛋白A1(apo-A1)等血液学指标,对上述指标中单因素分析,差异有统计学意义(P＜0.05)且具有临床意义的项目进行多因素二元Logistic回归分析,分析其与DHMCAS形成的相关性.结果 单因素分析显示,2组患者高血压史、TG、LDL-C水平差异具有统计学意义(P＜0.05);多因素二元Logistic回归分析显示,10年以上高血压(OR=1.876,P＜0.038)和TG(OR=1.085,P＜0.049)是DHMCAS形成的相关因素.结论 高血压和TG可能与DHMCAS的形成有关.%Objective To investigate risk factors of bilateral hyperdense middle cerebral artery sign (BHMCAS) formation.Methods Six hundred patients who underwent skull CT during hospitalization from 2011 to 2015 were selected for the study.Thirty patients with hounsfield unit (HU) in M1 segment of bilateral middle cerebral artery over 43 and the density ratio over 1.2 were designated as the BHMCAS group,and another 30 patients hospitalized during the same period were assigned as the control group.Such medical data as gender,age,histories of hypertension/diabetes mellitus/smoking/alcoholism,history of transient ischemic attack (TIA),hematocrit value (HCT),platelet(PLT),total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL-C),high density lipoprotein (HDL-C),fibrinogen (FIB),blood free fatty acid (FFA) and apolipoprotein A1 (apo A 1) were collected for laboratory analyses.Univariate analysis and binary logistic regression analysis were performed on those data that had statistical significance (P ＜ 0.05) and clinical value,and then,the association between those data and BHMCAS formation was analyzed in the study.Results Univariate analysis showed that there were statistically significant differences in hypertension and the levels of TG、LDL-C (P ＜ 0.05).Multi-factor binary logistic regression analysis indicated that the odds ratio (OR) of 1.876 (P ＜0.038) and odds ratio of 1.085 (P ＜0.049) in those hypertension patients for over 10 years were associated factors of BHMCAS.Conclusion Hypertension and TG might be associated with the formation of DHMCAS.