Table_1_Risk Profile of Ischemic Stroke Caused by Small-Artery Occlusion vs. Deep Intracerebral Hemorrhage.DOCX

Background: Small-artery occlusion (SAO) subtype accounts for a quarter of the cases of ischemic stroke and is mainly caused by pathological changes in cerebral small vessels, which also involve in deep intracerebral hemorrhage (dICH). However, the factors that drive some cases to SAO and others to dICH remained incompletely defined.
Material and Methods: This study is a cross-sectional study from the China National Stroke Registry that included consecutive patients with ischemic stroke or intracerebral hemorrhage between August 2007 and September 2008. We compared the risk profile between the two subgroups using multivariable logistic regression.
Results: A total of 1,135 patients with SAO stroke and 1,125 dICH patients were included for analyses. Generally, patients with SAO stroke were more likely to be male (odds ratio = 0.74, confidence interval = 0.58–0.94) and have diabetes (0.30, 0.22–0.40), higher atherogenic lipid profiles, higher body mass index (0.96, 0.94–0.99), higher waist/height ratio (0.12, 0.03–0.48), higher platelet count (0.84, 0.77–0.91), and higher proportion of abnormal estimated glomerular filtration rate (<90, ml/min/1.73 m2) (0.77, 0.62–0.95). Conversely, patients with dICH were more likely to have higher blood pressure parameters, inflammation levels (white blood cell count: 1.61, 1.48–1.76; high sensitivity C-reactive protein: 2.07, 1.36–3.16), and high-density lipoprotein-c (1.57, 1.25–1.98).
Conclusions: The risk profile between SAO stroke and dICH were different. Furthermore, despite of traditional indexes, waist/height ratio, platelet count, inflammation levels, lipid profile, and estimated glomerular filtration rate also play important roles in driving arteriolosclerosis into opposite ends.

研究背景：小动脉闭塞（small-artery occlusion, SAO）亚型占缺血性脑卒中病例的四分之一，其主要由脑小血管病理改变引发，而此类病理改变同样可累及脑深部出血（deep intracerebral hemorrhage, dICH）。但目前尚未完全明确究竟是何种因素导致部分患者进展为SAO，而另一部分患者则发展为dICH。
材料与方法：本研究为基于中国国家脑卒中登记库的横断面研究，纳入了2007年8月至2008年9月期间连续收治的缺血性脑卒中或脑出血患者。本研究采用多变量logistic回归分析，对比了两个亚组的风险特征。
研究结果：本研究共纳入1135例SAO脑卒中患者与1125例dICH患者进行分析。总体而言，SAO脑卒中患者更常为男性（比值比=0.74，95%置信区间=0.58~0.94），合并糖尿病的比例更高（比值比=0.30，95%置信区间=0.22~0.40），且具有更高的致动脉粥样硬化血脂谱、更高的体质量指数（比值比=0.96，95%置信区间=0.94~0.99）、更高的腰围身高比（比值比=0.12，95%置信区间=0.03~0.48）、更高的血小板计数（比值比=0.84，95%置信区间=0.77~0.91），以及估算肾小球滤过率异常（<90 ml/min/1.73 m²）的比例更高（比值比=0.77，95%置信区间=0.62~0.95）。与之相反，dICH患者往往具有更高的血压参数水平、更高的炎症指标水平（白细胞计数：比值比=1.61，95%置信区间=1.48~1.76；高敏C反应蛋白：比值比=2.07，95%置信区间=1.36~3.16），以及更高的高密度脂蛋白胆固醇水平（比值比=1.57，95%置信区间=1.25~1.98）。
研究结论：SAO脑卒中与dICH患者的风险特征存在显著差异。此外，除传统临床指标外，腰围身高比、血小板计数、炎症指标、血脂谱及估算肾小球滤过率在推动小动脉硬化进展为两种截然相反的结局中也发挥了重要作用。