国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
2023-06-30
已发表文章
主要研究背景及目的
Cerebral small vessel disease (CSVD) is a series of clinical, imaging and pathological syndromes caused by the cerebral arterioles, capillaries and venules. Some studies have shown that CSVD is common in patients with intracranial atherosclerotic stenosis, and the coexistence rate can reach 49.5%. Intracranial large atherosclerosis is likely to affect the occurrence and development of small vascular diseases through results and functions. Previous studies have mainly focused on the relationship between extracranial arteries, such as carotid arteries, and CSVD. The relationship between intracranial atherosclerosis and cerebrovascular diseases needs to be further studied. This study aims to evaluate the relationship between intracranial atherosclerosis and different phenotypes and total burden of CSVD through the Poly-vasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study in the Chinese community.
方法
Methods: A total of 3061 community-dwelling residents in Lishui city in China of the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study were involved. Intracranial atherosclerosis was grouped by plaque with stenosis and burden. Four imaging markers including white matter hyperintensity (WMH), lacunes, cerebral microbleeds (CMBs) and perivascular spaces (PVS), were assessed according to total CSVD burden score. Logistic regression or ordinal logistic regression models were used and OR or cORs model was used to estimate the relationship of intracranial atherosclerosis and CSVD markers and burdens.
结论
Based on a Chinese community population, there may be an association between intracranial atherosclerosis and CSVD, but its mechanism in relation to vascular risk factors still needs to be clarified.
主要结果
The mean age was 61.20 ± 6.68 years, and 1424 (46.52%) were men among 3061 participants included at baseline. Intracranial atherosclerotic burden was associated with the severity of the lacunes (OR = 4.18, 95% confidence interval [CI] = 1.83–9.58), modified WMH burden (cOR = 1.94, 95% CI = 1.01–3.71), presence of CMBs (OR = 2.28, 95% CI = 1.05–4.94), and CMB burden (OR = 2.23, 95% CI = 1.03–4.80). However, it was not associated with the WMH burden and PVS. Intracranial atherosclerotic burden was associated with CSVD burden (Wardlaw: cOR = 2.73, 95% CI = 1.48–5.05; Rothwell: cOR = 2.70, 95% CI = 1.47–4.95). The association between intracranial atherosclerosis and CSVD was obvious in participants with both anterior and posterior circulation artery stenosis.