321/321L stainless hlau capillary raj Association ntawm cov teeb meem dawb hyperintensity nrog coronary artery calcification nyob rau hauv cov neeg noj qab haus huv: ib tug hla-sectional kawm

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Dawb teeb meem hyperintensity (WWH) yog ib qho kev tshawb pom ntawm magnetic resonance imaging (MRI) ntawm lub hlwb thiab paub tias muaj kev cuam tshuam cov hlab ntsha me hauv lub hlwb.Lub hom phiaj ntawm peb txoj kev tshawb fawb yog los tshawb xyuas lub koom haum ntawm coronary artery calcium (CCA) nrog WMH thiab qhia txog kev sib raug zoo ntawm WMH thiab cov teeb meem muaj feem cuam tshuam rau atherosclerosis hauv cov neeg noj qab haus huv loj.Qhov kev tshawb nrhiav rov qab no suav nrog 1337 tus neeg uas tau txais lub hlwb MRI thiab suav tomography nrog CAC kev ntsuam xyuas ntawm lub tsev kho mob tertiary.GVM ntawm lub hlwb tau txhais tias yog Fazekas qhab nia ntau dua 2 cov ntsiab lus ntawm MRI ntawm lub hlwb.Intracranial arterial stenosis (ICAS) kuj tau soj ntsuam thiab paub tseeb tias thaum angiography pom ntau dua 50% stenosis.Cov koom haum ntawm cov kev pheej hmoo, CAC thiab ICAS cov qhab nia nrog lub hlwb HBG tau raug soj ntsuam los ntawm kev txheeb xyuas kev sib txawv ntawm ntau yam.Hauv kev txheeb xyuas ntau yam, pawg nrog cov qhab nia CAC siab dua tau pom tias muaj kev sib koom ua ke nrog periventricular thiab mob siab heev nyob rau hauv koob tshuaj.Lub xub ntiag ntawm ICAS kuj tseem cuam tshuam nrog lub hlwb HBH, thiab ntawm cov kev hloov pauv hauv chaw kho mob, hnub nyoog thiab kub siab yog qhov muaj feem pheej hmoo.Hauv kev xaus, hauv cov neeg noj qab haus huv, CAC tau cuam tshuam nrog lub hlwb WMH, uas tuaj yeem muab pov thawj los txheeb xyuas cov tib neeg muaj kev pheej hmoo rau lub hlwb WMH nrog rau CAC cov qhab nia.

Stainless hlau 321 Coil Tube Chemical Composition

Cov tshuaj muaj pes tsawg leeg ntawm 321 stainless hlau coil tubing yog raws li nram no:
- Cov pa roj carbon: 0.08% max
- Manganese: 2.00% max
- Nickel: 9.00% min

321/321L stainless hlau 8 * 0.2 capillary raj

Stainless hlau 321 Coil Tube Mechanical Properties

321/321L stainless hlau 8 * 0.2 capillary raj

Raws li Stainless Hlau 321 Coil Tube Chaw Tsim Tshuaj, cov khoom siv ntawm stainless hlau 321 coil tubing yog tabulated hauv qab no: Tensile Strength (psi) Yield Strength (psi) Elongation (%)

321/321L stainless hlau 8 * 0.2 capillary raj

Dawb teeb meem hyperintensity (WWH) yog ib qho kev pom nyob rau hauv T2-hnyav thiab kua-attenuated magnetic resonance imaging (MRI) inversion rov qab (FLAIR) sequences ntawm lub hlwb 1,2.Txawm hais tias qhov tseeb pathophysiological mechanism ntawm HHH tsis paub, nws tau pom tias muaj feem cuam tshuam nrog kev pheej hmoo rau atherosclerosis xws li kev laus, kub siab, ntshav qab zib, haus luam yeeb, thiab rog, qhia txog kev koom tes ntawm vascular mechanisms rau kev loj hlob ntawm HHH3,4,5. ,6.Ib., 7, 8, 9, 10.Cov kev tshawb fawb pathological kuj tau qhia tias HHH yog tshwm sim los ntawm kev puas tsuaj ntawm vascular integrity, yog li lees paub tias HHH yog ib qho kev xav txog cov kab mob me me hauv lub hlwb11.Tsis tas li ntawd, SHG yog qhov tseem ceeb hauv kev kho mob raws li nws tau pom tias muaj kev cuam tshuam rau qhov tshwm sim thiab qhov tshwm sim ntawm ntau yam kab mob hauv lub paj hlwb, nrog rau kev paub tsis meej, dementia, kev nyuaj siab, kev ntxhov siab, thiab mob stroke12,13,14,15,16,17,18, 19, 20, 21, 22, 23.
Coronary calcium assessment (CAC) yog suav tias yog ib qho yooj yim thiab txhim khu kev ntsuas ntawm ib tus neeg qhov kev pheej hmoo ntawm atherosclerosis thiab tau pom tias muaj kev cuam tshuam nrog ischemic stroke thiab cranial artery stenosis, nrog rau cov kab mob plawv 24,25.Cov kab mob cerebral me me nkag tau yooj yim nrog atherosclerosis ntawm cov hlab ntsha loj intracranial vim tias cov hlab ntsha me me uas muab cov teeb meem dawb los ntawm cov hlab ntsha loj basilar.Ntau cov kev tshawb fawb tau txheeb xyuas qhov kev sib raug zoo ntawm SHH thiab cov kev pheej hmoo rau atherosclerosis lossis carotid atherosclerosis, txawm li cas los xij, tsuas yog qee qhov kev tshawb fawb tau tsom mus rau kev sib raug zoo ntawm SAS lub nra thiab SHH, thiab cov kev tshawb fawb no tsuas yog ua rau cov neeg laus lossis cov txiv neej 29, 30, 31.32.
Nrog rau kev muaj ntau ntxiv ntawm neuroimaging nyob rau hauv xyoo tas los no, qhov kev nthuav dav siab thiab qhov tseem ceeb ntawm HHH tau txais kev lees paub ntau ntxiv tias yog qhov kev kwv yees ntawm kev paub txog kev poob qis thiab mob stroke tshwm sim19,20,21,22,23.Qhov kev txhawb siab rau txoj kev tshawb fawb no yog tias yog CAC cov qhab nia tuaj yeem siv rau hauv kev kho mob los kwv yees qhov kev pheej hmoo ntawm SHH, tus kwv yees ntawm ntau yam kab mob hauv lub paj hlwb, nws tuaj yeem yog ib qho yooj yim thiab siv tau los txiav txim siab qhov txiaj ntsig ntawm lwm yam kev tshawb fawb tib neeg, xws li raws li MRI ntawm lub hlwb 19,20,21,22,23.Peb xav tias HHH muaj feem cuam tshuam nrog CCA lub nra, qhov taw qhia ntawm atherosclerosis, hauv ntau tus neeg noj qab haus huv hauv cov pej xeem.Tsis tas li ntawd, peb nrhiav kev pab kom nkag siab txog cov txheej txheem hauv qab ntawm txoj kev loj hlob ntawm HHH los ntawm kev txheeb xyuas cov xwm txheej muaj feem cuam tshuam txog kev kho mob.Yog li, lub hom phiaj tseem ceeb ntawm txoj kev tshawb no yog los tshawb xyuas kev koom tes ntawm CAC nrog WMH hauv cov neeg noj qab haus huv.Qhov thib ob, lub hom phiaj ntawm txoj kev tshawb fawb no yog txhawm rau txheeb xyuas qhov kev sib raug zoo ntawm SHG thiab cov xwm txheej txaus ntshai rau atherosclerosis.
Qhov kev tshawb fawb no yog ib qho kev tshawb nrhiav kev rov qab los ntawm kev tshawb fawb los ntawm cov pej xeem.Peb tau tshawb xyuas cov ntaub ntawv hluav taws xob ntawm cov neeg koom nrog uas tau kuaj mob, suav nrog lub hlwb MRI thiab magnetic resonance angiography (MRA), ntawm Gangbuk Samsung Tsev Kho Mob General Medical Centers hauv Seoul thiab Suwon thaum Lub Ib Hlis 2016 thiab Kaum Ob Hlis 2019. Cov pej xeem suav nrog cov kev kawm uas tau txais CAC suav tomography ( CT) thiab kev kuaj pom lub hlwb ua ib feem ntawm kev kuaj xyuas lub cev, uas yog cov kev kuaj xyuas kev noj qab haus huv hauv Kauslim.Rau kev siv, Kaus Lim Kauslim txoj cai xav kom txhua tus neeg ua haujlwm yuav tsum tau kuaj xyuas kev kho mob txhua xyoo lossis ob xyoos, yog li ntau tus neeg tuaj koom yog cov neeg ua haujlwm lossis tsev neeg ntawm cov neeg ua haujlwm ntawm ntau lub tuam txhab lossis tsoomfwv hauv nroog.
Ntawm 3983 tus neeg, 2646 raug cais tawm vim li cas hauv qab no: a) kev tsis pom zoo nrog kev siv cov ntaub ntawv kho mob rau txhua qhov kev tshawb fawb hauv daim ntawv nug tus kheej ua ntej kev xeem (n = 376);yog tias rov kuaj dua thaum lub sijhawm (n = 43), cov tib neeg uas muaj kev sim rov ua dua raug cais tawm, thiab CT thiab lub hlwb kev kuaj pom nrog CAC kev ntsuam xyuas tau ua nyob rau tib hnub lossis lub sijhawm tsis ntev los no tau raug xaiv rau txoj kev tshawb no;(c) paub dementia, Parkinson's disease.keeb kwm, hydrocephalus, kev phais lub hlwb yav dhau los, qog hlwb, kab mob moyamoya, mob stroke lossis hemorrhage (n = 47);(d) cov tib neeg uas muaj cov kab mob loj hauv lub hlwb pom los ntawm kev txheeb xyuas cov duab, piv txwv li, vim ua ntej encephalomalacia vim mob stroke (qhov loj ntawm txoj kab uas hla ntau dua 15 hli) los yog laus raug mob hemorrhage, arteriovenous malformation, los yog neoplastic lesion (n = 46);(e) Cov neeg uas muaj MRI lossis MRA tsis txaus rau kev txheeb xyuas duab (n = 2);(f) cov tib neeg uas tsis tau txais CT ntawm CAC nplai (n = 1796);(g) cov tib neeg uas tsis muaj cov ntaub ntawv tus lej xav tau rau kev tshuaj xyuas, suav nrog lub cev qhov ntsuas lub cev (BMI) thiab qib homocysteine ​​​​(n = 336).Daim ntawv qhia txog kev nrhiav neeg tuaj koom kev kawm yog qhia hauv daim duab 1.
Sau ib daim ntawv qhia txog cov neeg tuaj koom.MRI magnetic resonance imaging, MRA magnetic resonance angiography, periventricular white matter hyperintensity PVWMH, deep white matter hyperintensity DWMH.
Yog li, 1337 yam (txhais tau tias muaj hnub nyoog 51.63 ± 9.20 xyoo, hnub nyoog li ntawm 20-89 xyoo, 1157 [86.54%] txiv neej cov neeg mob) tau suav nrog hauv txoj kev tshawb no.Txhua tus neeg koom tau raug soj ntsuam rov qab rau kev soj ntsuam thiab kev tshawb pom radiographic.Txoj kev tshawb no tau ua raws li cov hauv paus ntsiab lus ntawm Kev Tshaj Tawm ntawm Helsinki thiab tau pom zoo los ntawm Pawg Saib Xyuas Kev Tshawb Fawb (IRB) ntawm Gangbuk Samsung Tsev Kho Mob (IRB No. 2020-12-036-006).IRB ntawm Kangbuk Samsung Tsev Kho Mob tau zam qhov kev tso cai pom zoo vim yog siv cov ntaub ntawv tsis raug txheeb xyuas thiab rov qab tsim kev tshawb fawb.Txhua txoj kev tshawb fawb tau ua raws li cov lus qhia thiab cov kev cai.
Peb tau sau cov ntaub ntawv kho mob tus kheej suav nrog poj niam txiv neej, hnub nyoog, BMI, systolic thiab diastolic ntshav siab, keeb kwm kev haus luam yeeb, kev ua lub cev, thiab kev kuaj mob thiab kev kho mob ntshav siab, ntshav qab zib, hyperlipidemia, thiab kab mob plawv.Los ntawm cov lus nug uas tus kheej tswj hwm tus kheej, peb tau sau cov ntaub ntawv ntawm txhua tus neeg cov keeb kwm kev kho mob thiab keeb kwm ntawm kev haus luam yeeb, nrog rau seb lawv puas koom nrog lub cev muaj zog ntau dua 10 feeb tsawg kawg 3 zaug hauv ib lub lis piam.
Vim tias txhua tus neeg tuaj koom tau teem sijhawm mus kuaj ntawm Ganbuk Samsung Tsev Kho Mob General Medical Center, kev kuaj sim tau ua nyob rau tib hnub li MRI ntawm lub hlwb thiab MRA tom qab 12-teev nrawm, thiab cov ntaub ntawv suav nrog cov piam thaj, glycated hemoglobin (HbA1c), qib. Ntawm tag nrho cov cholesterol, LDL cholesterol, HDL cholesterol, triglycerides thiab homocysteine ​​​​.
Arterial hypertension tau txiav txim siab tam sim no tau txais cov tshuaj antihypertensive, systolic ntshav siab ≥ 140 mmHg.los yog diastolic ntshav siab ≥ 90 mmHg33.Ntshav qab zib tau txhais tau tias yog kev siv tshuaj tiv thaiv kab mob tam sim no, yoo ntshav qabzib ≥ 126 mg / dL, lossis HbA1c ≥ 6.5%.Dyslipidemia tau txhais tau tias yog siv cov tshuaj lipid-txo qis tam sim no, tag nrho cov roj cholesterol ≥240 mg / dl, tsawg-density lipoprotein cholesterol ≥160 mg / dl, high-density lipoprotein cholesterol <40 mg / dl, lossis triglycerides ≥200 mg / dl35.
Txhua tus neeg koom nrog MRI ntawm lub hlwb thiab MRA nrog rau yim-channel lub taub hau kauj siv 1.5 T MRI scanner (Optima MR360, GE Healthcare, Milwaukee, Wisconsin lossis Signa HDxt, GE Healthcare, Milwaukee, Wisconsin).Cov txheej txheem imaging muaj xws li axial T1-hnyav dluab (repetition time [TR]/echo time [TE] = 417–450/9 ms or 400–450/10 ms), T2-weighted images (TR/TE = 4343–4694 ) ./100-110 ms lossis 4084-4494/95-104 ms), FLAIR cov duab (TR/TE = 11000/127-138 ms los yog 8800/128-130 ms) thiab 3D time-of-flight (TOF) cov duab (TR /TE = 28/7 ms lossis 27/3 ms, hlais thickness = 1.2 mm).Slice thickness yog 5 hli rau tag nrho cov duab raws tu qauv tshwj tsis yog TOF MRA.
Lub degree ntawm periventricular thiab tob WMH raug soj ntsuam cais raws li txhua yam kev kawm Fazekas scale1, raws li qhia nyob rau hauv Ntxiv daim duab 1 online.PVWMH tau qhab nia raws li hauv qab no: 0 = tsis muaj, 1 = cap los yog nyias hauv ob sab phlu, 2 = du halo, 3 = irregular periventricular hyperintensity extending into deep white matter.DWMH yog cais raws li nram no: 0 = absent, 1 = punctate, 2 = lesions pib coalesce, 3 = loj cheeb tsam ntawm confluence.Vim tias lub hlwb HBH qib 2 lossis siab dua paub tias yog qhov tseem ceeb hauv kev kho mob vim tias nws muaj feem cuam tshuam rau cov tsos mob thiab kev loj hlob, peb faib cov neeg mob nrog Fazekas cov qhab nia ntawm 2 thiab 3 rau PVBVH thiab DGBV36,37.
TOF MRA tsom xam, raws li warfarin-aspirin symptomatic intracranial kab mob (WASID), txhais tau tias intracranial artery stenosis (ICAS) raws li intracranial artery stenosis ntau dua 50% 38.Cov hlab ntsha suav nrog hauv kev tshuaj xyuas yog cov hlab ntsha sab hauv carotid los ntawm ntu ntu ntu ntu mus rau ntu M2 ntawm nruab nrab cerebral hlab ntsha, ntu A2 ntawm cov hlab ntsha sab hauv hlwb, ntu P2 ntawm cov hlab ntsha tom qab lub paj hlwb, cov hlab ntsha basilar, thiab cov hlab ntsha intracranial. cov hlab ntsha.ntu ntawm cov hlab ntsha vertebral.
Txhua qhov kev ntsuam xyuas hluav taws xob tau ua los ntawm tus kws kho mob neuroradiologist (JYK), uas tsis paub txog tag nrho cov ntaub ntawv kho mob thiab chaw kuaj mob.Qhov kev ntseeg siab ntawm qhov pom ntawm qhov ntsuas ntawm cov neeg soj ntsuam tau soj ntsuam los ntawm tus kws tshaj lij xov tooj cua thib ob (JYC) ntawm 700 qhov kev xaiv xaiv thiab nyob rau hauv 2 lub hlis tom qab nyeem thawj zaug.Txheeb xyuas qhov kev cia siab ntawm tus neeg soj ntsuam.Kev ntsuam xyuas pom ntawm PVWMH, DWMH, thiab ICAS tau pom zoo rau tus kws tshaj lij (Cohen-weighted kappa: 0.7, 0.81, thiab 0.67, feem; n = 700) thiab tus kws tshaj lij (Cohen-weighted kappa: 0.92, 0.88, thiab 65, raws; n = 1339) raws tu qauv.
CAC cov qhab nia raug soj ntsuam hauv cov tib neeg uas tau txais CT los ntsuas CAC hauv 5 xyoos ntawm lub hlwb MRI thiab MRA39.Ntawm 1,337 tus neeg, 686 tau kuaj mob hlwb rau tib hnub thiab 651 rau lwm hnub hauv 5 xyoos.
Cov chaw hauv Seoul thiab Suwon siv mAc (310 mA × 0.4 s) raj tam sim no ntawm 2.5 mm thickness, 400 ms rotation time, 120 kV tube voltage, thiab 124 ECG-dependent dose modulation.Raws li Agatston et al.40, CAC raug xam los ntawm 4 loj epicardial coronary arteries (sab laug lub ntsiab, sab laug anterior nqis, sab laug circumflex, thiab txoj cai coronary hlab ntsha).Tus kws tshaj lij CT tau dig muag los ntawm cov ntaub ntawv hais txog qhov kev kawm thiab CAC cov qhab nia tau txiav txim siab siv HEARTBEAT-CS software (Philips, Cleveland, OH, USA).Cov qhab nia CAC tau muab faib ua peb pawg: 0, 1-100, thiab> 100.
Cov yam ntxwv hauv paus tau muab piv rau cov kev kawm uas muaj thiab tsis muaj lub hlwb WMH siv χ2 test rau categorical variables thiab Student's t-test or Mann-Whitney test for nruam variables, raws li qhov tsim nyog.Feem ntau faib cov sib txawv tau nthuav tawm raws li qhov txhais tau tias ± tus qauv sib txawv, thaum tsis yog ib txwm faib cov hloov pauv tau nthuav tawm raws li qhov nruab nrab thiab qhov sib txawv.Dummy variables tau qhia rau qhov tsis muaj qhov tseem ceeb ntawm categorical variables.
Multivariate logistic regression tsom xam tau ua los xam qhov sib txawv ntawm qhov sib txawv (ORs) thiab 95% kev ntseeg siab ib ntus (CIs) los ntsuas kev sib raug zoo ntawm lub hlwb WMH thiab CAC cov qhab nia thiab muaj feem cuam tshuam rau atherosclerosis.Txij li HHH qhov muaj ntau ntxiv nrog lub hnub nyoog thiab sib txawv ntawm kev sib deev, txhua qhov kev tshuaj ntsuam sib txawv tau ua los ntsuas kev sib koom ua ke ntawm lwm qhov sib txawv thiab HHH18 hloov kho rau hnub nyoog thiab poj niam txiv neej.Lwm tus qauv logistic regression tau siv los ntsuas seb qhov qhab nia CAC puas muaj kev ywj pheej nrog lub paj hlwb SHG, txawm tias tom qab kho rau atherosclerosis muaj feem cuam tshuam thiab ICAS yog qhov tsis txaus ntseeg uas tau tshaj tawm tias muaj feem cuam tshuam nrog SHH hauv cov ntawv tshaj tawm dhau los 10, 26, 27, 41 . Qauv 1 tau hloov kho rau hnub nyoog thiab poj niam txiv neej, Qauv 2 tau hloov kho rau hnub nyoog, poj niam txiv neej, thiab muaj feem cuam tshuam rau atherosclerosis (BMI, kub siab, ntshav qab zib, dyslipidaemia, tam sim no lossis yav dhau los haus luam yeeb, kev tawm dag zog tsis tu ncua, kab mob keeb kwm ntawm kab mob plawv thiab qib cystine. ).kho;Qauv 3 tau hloov kho rau hnub nyoog, poj niam txiv neej, muaj feem cuam tshuam rau atherosclerosis, thiab muaj ICAS.Lub xub ntiag ntawm lub hlwb WMH raug soj ntsuam raws li CAC cov qhab nia qeb siv CAC qhab nia 0 raws li qhov ntsuas.
Kev txheeb xyuas txheeb cais tau ua tiav siv Stata version 16.1 (StataCorp, College Station, Texas, USA) thiab R studio version 3.6.3 (RStudio, Boston, Massachusetts, USA).Ob-tailed p-tus nqi <0.05 tau suav tias yog qhov tseem ceeb.
Cov yam ntxwv tseem ceeb ntawm 1337 tus neeg tau pom nyob rau hauv Table 1. Lub hnub nyoog nruab nrab ntawm cov neeg koom, kwv yees los ntawm lub sijhawm ntawm MRI ntawm lub hlwb, yog 51.63 ± 9.20 xyoo, thiab 86.54% ntawm cov neeg kawm yog txiv neej.Qhov tseem ceeb ntawm kev pheej hmoo rau atherosclerosis hauv pawg no yog kev haus luam yeeb tam sim no lossis yav dhau los (57.82%), tom qab ntawd los ntawm dyslipidemia (51.76%) thiab kub siab (28.65%).Raws li kev hloov pauv hluav taws xob, 158 tus neeg mob (11.82%) muaj PVWMH, 148 (11.07%) muaj DWMH, thiab 21 (1.57%) muaj ICAS.Hais txog CAC cov qhab nia, 849 cov kev kawm (63.5%) muaj CAC qhab nia ntawm 0, 332 (24.83%) tau qhab nia nruab nrab ntawm 0 thiab 100, thiab 156 (11.67%) tau qhab nia siab dua 100.
Hauv kev tshuaj ntsuam tsis sib xws, hnub nyoog, poj niam txiv neej, thiab feem ntau muaj feem cuam tshuam rau atherosclerosis, tshwj tsis yog BMI, dyslipidemia, thiab kev haus luam yeeb tam sim no lossis yav dhau los, tau cuam tshuam nrog lub hlwb HHH (p <0.05) (Table 2).Cov tib neeg uas muaj PVWMH thiab DWMH laus dua thiab muaj lub nra hnyav dua ntawm kev kub siab, ntshav qab zib, keeb kwm ntawm kab mob plawv, CAC, thiab ICAS dua li cov tib neeg tsis muaj PVWMH thiab DWMH.Hauv kev txheeb xyuas qhov tsis sib xws, feem ntau ntawm cov poj niam thiab cov neeg kawm hauv pawg WMH tau tshaj tawm tias lawv tau tawm dag zog tsis tu ncua.Qhov nruab nrab (interquartile range; IQR) CAC yog 62 (IQR 0-269.5) hauv pawg PVWMH thiab 46.5 (IQR 0-192) hauv DWMH pawg.Kev faib tawm ntawm CAC pawg los ntawm lub xub ntiag ntawm PVWMH thiab DWMH yog qhia hauv daim duab.2. Qhov kev faib ua feem ntawm pawg nrog cov qhab nia CAC siab dua tau nce nrog cov qib ntawm comorbid WMH.
Feem pua ​​​​ntawm CAC cov qhab nia raws li muaj PVMWH (a), DWMH (b), thiab PVWMH lossis DWMH (c).Calcification ntawm coronary hlab ntsha ntawm SAS, cov teeb meem dawb hyperintensity SHG, periventricular dawb teeb meem hyperintensity HVBV, tob dawb teeb meem hyperintensity SHVH.
Multivariate regression tsom xam kho rau hnub nyoog (LOSSIS 1.13; 95% CI 1.10-1.16; LOSSIS 1.11; 95% CI 1.08-1.14) thiab kub siab (los yog 2.29; 95% CI 1.50–3.50, OR 95% CI 1.9) .Feem ntau) yog PVWMH tom qab kho lub hnub nyoog, poj niam txiv neej, atherosclerosis cov yam ntxwv (BMI, ntshav siab, ntshav qab zib mellitus, dyslipidemia, tam sim no lossis yav dhau los haus luam yeeb, kev tawm dag zog, keeb kwm ntawm cov kab mob plawv, thiab homocysteine ​​​​cov qib) thiab ywj pheej tseem ceeb soj ntsuam kev kwv yees ntawm DWMH thiab ICAS (tag nrho p <0.05) (Table 3).Tsis muaj kev koom tes tseem ceeb ntawm kev hloov kho WMH thiab kev sib deev, BMI, ntshav qab zib lossis dyslipidemia, keeb kwm ntawm kev haus luam yeeb, lossis kev tawm dag zog tsis tu ncua.
Txawm tias tom qab hloov kho rau cov teeb meem tsis meej pem, pawg nrog cov qhab nia CAC siab dua tau pom tias muaj kev sib koom ua ke nrog lub hlwb GMI nyob rau hauv cov koob tshuaj raws li piv rau pawg siv nrog CAC tus qhab nia ntawm 0. Rau PVWMH thiab DWMH, pawg nrog CAC qhab nia siab dua 100 ( LOSSIS 5.45; 95% CI 3.11–9.54 lossis 3.66; 95% CI 2.10–6.38) pom tias muaj kev sib raug zoo ntau dua li pawg nrog CAC cov qhab nia ntawm 0 txog 100 (los yog 2.22; 95% CI).1.36–3.61, LOSSIS 1.59;95% CI 0.98–2.58).Thaum sib piv cov koom haum nrog CAC ntawm PVWMH thiab DWMH pawg, tag nrho peb qhov kev ntsuam xyuas ntau yam qauv qhia tau tias muaj kev koom tes siab dua nrog PVWMH hauv ob pawg CAC cov qhab nia.Lub xub ntiag ntawm ICAS kuj pom tias muaj kev koom tes tseem ceeb nrog PVWMH (LOS 3.97, 95% CI 1.31-12.06) thiab DWMH (OR 7.11, 95% CI 2.33-21.77).
Variance inflation coefficients raug xam rau tag nrho cov qauv regression los ntsuam xyuas muaj peev xwm multicollinearity, thiab tsis pom muaj teeb meem multicollinearity (Table Ntxiv 1 online).
Hauv txoj kev tshawb no, qhov kev pheej hmoo ntawm cerebral SHH nce nrog nce CAC tus qhab nia nyob rau hauv koob tshuaj, thiab cov txiaj ntsig tau muaj txiaj ntsig zoo tom qab hloov kho comorbid muaj feem cuam tshuam rau atherosclerosis.Peb cov txiaj ntsig tau zoo ib yam nrog cov kev tshawb fawb yav dhau los uas qhia txog kev sib koom ua ke ntawm CAC thiab lub hlwb MRI qhov txawv txav, ntxiv txhawb kev koom tes ntawm CAC nrog cerebral me hlab ntsha atherosclerosis nrog rau cov hlab ntsha loj atherosclerosis29,30,31,32.
Interestingly, nyob rau hauv tag nrho peb lub multivariate tsom xam qauv, ORs rau CAC cov qhab nia yog me ntsis siab dua nyob rau hauv lub PVWMH pab pawg neeg dua nyob rau hauv DWMH pawg.Qhov sib txawv no tuaj yeem yog vim qhov tseeb tias qhov sib txawv ntawm cov txheej txheem pathophysiological thiab cov kev pheej hmoo raug suav tias yog ntawm PVWMH thiab DWMH11,42,43.PVWMHs feem ntau symmetrically tam sim no nyob rau hauv ob qho tib si cerebral hemispheres, qhia ib tug diffuse perfusion disorder, thaum DWMHs feem ntau muaj ib tug asymmetric tis, qhia tias lawv yog tshwm sim los ntawm ib tug focal perfusion teeb meem.Txij li cov cheeb tsam periventricular yog muab los ntawm cov hlab ntsha ntawm lub medulla ntev thiab perforating ceg [45], nws yog qhov tshwj xeeb tshaj yog muaj kev phom sij thaum autoregulatory mechanisms rau kev tswj xyuas lub paj hlwb perfusion tsis tu ncua los ntawm arteriosclerosis lossis lipoid hyalinosis [46, 47, 48, 49]Hypoperfusion thiab ischemia tshwm sim.Tshwj xeeb, ntau qhov kev tshawb fawb tau pom tias qhov tshwm sim ntawm cov kab mob atherosclerosis, xws li kub siab, ntshav qab zib mellitus, thiab muaj cov kab mob aortic atherosclerosis, feem ntau cuam tshuam nrog PVWMH50,51,52,53, txhawb peb qhov kev tshawb pom tias CAC qhab nia, hnub nyoog, thiab cov hlab ntsha. ntshav siab tau siab dua ORs rau PVWMH dua li DWMH hauv txhua tus qauv.
Nyob rau hauv txoj kev tshawb no, lub xub ntiag ntawm ICAS tau zoo txuam nrog lub hlwb HHH, qhov tshwm sim uas tuaj yeem piav qhia los ntawm qhov tseeb tias qhov tseem ceeb stenosis ntawm cov hlab ntsha loj intracranial txo qis hauv zos lossis hauv cheeb tsam cerebral perfusion, thiab qhov mob hypoperfusion no ua rau fatty hyalinosis, uas yog cov hauv qab mechanisms.WMH 26.54.
Raws li ntau cov kev tshawb fawb yav dhau los 3, 27, 28, 55 ua nyob rau hauv ntau pawg haiv neeg, peb txoj kev tshawb fawb kuj tau pom tias muaj hnub nyoog thiab kub siab ntawm nws tus kheej thiab cuam tshuam nrog lub hlwb HBG hauv kev tshuaj ntsuam ntau yam.Txawm li cas los xij, kev koom tes ntawm HHH thiab lwm yam kev pheej hmoo rau atherosclerosis tau pom cov txiaj ntsig sib xyaw hauv cov ntawv tshaj tawm dhau los 27,28,37,56.Cov laj thawj ntawm cov txiaj ntsig sib txawv no tuaj yeem yog vim qhov sib txawv ntawm cov neeg kawm, cov txheej txheem rau kev txiav txim siab muaj feem cuam tshuam, lossis cov txheej txheem siv los txheeb xyuas WMH, uas yuav tsum tau kawm ntxiv.
Ntau qhov kev txwv ntawm qhov kev tshawb fawb no yuav tsum tau sau tseg.Ua ntej, qhov no yog kev tshawb nrhiav rov qab ntawm cov neeg Esxias hauv lub chaw kho mob monobrand.Tej zaum yuav muaj kev pheej hmoo ntawm kev xaiv tsis ncaj vim tias coob tus neeg koom nrog kev kawm muaj hnub nyoog ua haujlwm, thiab ntau dua ib nrab ntawm lawv yog txiv neej, vim yog cov yam ntxwv tshwj xeeb ntawm Kaus Lim Qab Teb, uas xav kom cov tuam txhab tshuaj xyuas lawv cov neeg ua haujlwm tsis tu ncua.Txhawm rau txo qhov kev tsis ncaj ncees hauv kev tshawb fawb, kev kawm ntev, ntev, thiab kev kawm yav tom ntej xws li Rotterdam Study57 lossis Framingham Study58 yuav tsum tau ua.Yav dhau los, tau muaj ntau cov lus ceeb toom uas siv Rotterdam Txoj Kev Tshawb Fawb los tsom rau kev sib raug zoo ntawm lub hlwb SHG thiab ntau yam kev pheej hmoo rau atherosclerosis Association ntawm cohorts thiab kev tshawb fawb Framingham 4, 59, 60, 61, 62, 63. Txawm li cas los xij, txij li tsis muaj ib qho ntawm cov uas twb muaj lawm. Cov kev tshawb fawb tau tsom mus rau kev koom tes ntawm GIBD thiab CCA hauv cov neeg ib txwm muaj, peb cov txiaj ntsig yog qhov tseem ceeb ntawm kev kho mob.Qhov thib ob, txij li kev soj ntsuam MRI tau ua pom los ntawm cov kws kho hluav taws xob, lub hom phiaj yuav tsis txaus.Txawm li cas los xij, peb tau sim kov yeej qhov kev txwv no los ntawm kev suav nrog coob tus neeg tuaj koom thiab txhais cov ntsiab lus nrog tsawg kawg yog nruab nrab lossis siab dua WMH ua pab pawg zoo.Tsis tas li ntawd, peb tau ua qhov kev soj ntsuam ntawm cov neeg soj ntsuam thiab cov neeg soj ntsuam kev ntseeg siab, thiab cov txiaj ntsig tau pom zoo pom zoo.Nws kuj tseem tau tshaj tawm yav dhau los tias muaj kev sib raug zoo ntawm cov kev ntsuas qhov muag uas siv Fazekas nplai thiab ntsuas ntsuas ntsuas siv los ntsuas qib WMH64,65.Thib peb, cov tib neeg uas muaj kab mob hauv lub hlwb raug tshem tawm los ntawm kev siv cov lus nug ntawm tus kheej uas suav nrog keeb kwm kev kho mob yav dhau los thiab kev txheeb xyuas cov duab ntawm cov tib neeg uas muaj kab mob overt thiab yuav tsis lim tawm cov tib neeg uas muaj kab mob subclinical.Tsis tas li ntawd, lub paj hlwb MRI rau kev kuaj xyuas kev noj qab haus huv hauv peb lub tsev kho mob tsis suav nrog kev txhim kho cov duab, yog li muaj qhov ua tau ploj lawm qhov kev kuaj mob ntawm lub paj hlwb txhim kho, uas tsis pom tseeb ntawm T1-weighted, T2-weighted thiab FLAIR cov duab, thiab qhov tseeb tsis yog siab.Piv nrog rau kev txhim kho MRA, qhov muaj nyob ntawm ICAS tau ntsuas raws li qhov qis.Plaub, vim tias feem ntau ntawm cov neeg koom nrog hauv txoj kev tshawb no yog los ntawm cov neeg noj qab haus huv thiab feem ntau tsis muaj kab mob, qhov feem pua ​​​​ntawm cov neeg raug kev txom nyem los ntawm ICAS kuj tsawg.
Txawm li cas los xij, txoj kev tshawb no suav nrog cov neeg noj qab haus huv ntau dua li cov kev tshawb fawb yav dhau los saib ntawm kev sib koom ua ke ntawm SHG thiab SAS, thiab rau peb txoj kev paub, qhov no yog thawj txoj kev tshawb fawb suav nrog cov neeg laus noj qab haus huv yam tsis tau qhia txog poj niam txiv neej lossis hnub nyoog.Cov kev txwv ntawm kev kawm 31,32.
Qhov tseem ceeb ntawm lub hlwb WMH thiab ntau yam kev cuam tshuam txog kev puas siab puas ntsws xws li dementia thiab mob hlab ntsha tawg yog qhov tseem ceeb vim tias muaj qhov nce ntxiv ntawm lub paj hlwb thiab lub neej expectancy, tab sis cov kab mob no tseem tsis tau muaj zog.Lub xub ntiag ntawm HHH qhov txhab nyob rau hauv lub hlwb yog txuam nrog kev loj hlob ntawm kev txawj ntse poob, dementia, kev nyuaj siab, thiab mob stroke, thiab muaj kev loj hlob pov thawj uas tswj tej yam kev pheej hmoo rau atherosclerosis yuav tiv thaiv HHH12, 13, 14, 15, 16, 17, 18. , 19 , 20 , 21 , 22 , 23 , 66 , 67 , 68 , 69. Yog li, peb cov txiaj ntsig tuaj yeem muab pov thawj rau kev tshuaj xyuas cov tib neeg muaj kev pheej hmoo rau lub hlwb HHH, qhov tseem ceeb ntawm kev pheej hmoo thiab kev kwv yees rau ntau yam kab mob neurological, nrog rau kev siv cov tau qhab nia CAC, yog li txheeb xyuas cov neeg mob uas tuaj yeem tau txais txiaj ntsig los ntawm kev kuaj mob hnyav thiab kev kho mob.seb CAC ua lub luag haujlwm tseem ceeb thiab muaj kev ywj pheej hauv kev txhim kho WMH hauv kev tshawb fawb ntev thiab yav tom ntej los ntawm cov cheeb tsam sib txawv, pawg hnub nyoog thiab haiv neeg, thiab lwm yam MRI cov cim ntawm cov kab mob cerebral me me yuav tsum suav nrog rau kev nkag siab zoo.
Hauv kev xaus, CAC qhab nia nrog rau hnub nyoog thiab kub siab tau cuam tshuam nrog lub hlwb WMH hauv cov neeg noj qab haus huv loj.CAC tus qhab nia yog qhov qhia txog lub nra ntawm atherosclerotic thiab muaj lub luag haujlwm hauv kev kwv yees qhov kev pheej hmoo ntawm cerebral HHH hauv kev kho mob.
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