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Li-slide tse bonts'ang lingoloa tse tharo selaeteng se seng le se seng.Sebelisa likonopo tse ka morao le tse latelang ho tsamaea ka har'a li-slide, kapa likonopo tsa selaoli se qetellong ho tsamaea selaeteng ka seng.
ASTM A249 269 Seamless 310 Stainless Steel Coil Tube
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1).Boima:3.175-50.8mm(1/8″-2inc)
2).WT: 0.3 - 3mm
3).Lihlopha: 304 316304 304L 316 316L 310S 2205 2507 625 825 joalo-joalo.
4).E tloaelehileng: GB/ISO/EN/ASTM/JIS, joalo-joalo.
7. Mamello: OD: +/-0.01mm;Botenya: +/-0.01%.
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9. Boitsebiso: 304, 304L, 316L, 321, 301, 201, 202, 409, 430, 410, alloy 625 825 2205 2507 joalo-joalo.
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14:Molemo:re moetsi.ka boleng bo botle le theko e utloahalang.re ka kopana le uena tsohle tse hlokahalang.re profession
Likarolo tsohle tsa Lik'hemik'hale le Lintho tsa 'Mele bakeng sa tšepe e sa hloekang ha li ntse li phalla:
| Lintho tse bonahalang | ASTM A269 Sebopeho sa Lik'hemik'hale % Max | ||||||||||
| C | Mn | P | S | Si | Cr | Ni | Mo | NB | Nb | Ti | |
| TP304 | 0.08 | 2.00 | 0.045 | 0.030 | 1.00 | 18.0-20.0 | 8.0-11.0 | ^ | ^ | ^ . | ^ |
| TP304L | 0.035 | 2.00 | 0.045 | 0.030 | 1.00 | 18.0-20.0 | 8.0-12.0 | ^ | ^ | ^ | ^ |
| TP316 | 0.08 | 2.00 | 0.045 | 0.030 | 1.00 | 16.0-18.0 | 10.0-14.0 | 2.00-3.00 | ^ | ^ | ^ |
| TP316L | 0.035 D | 2.00 | 0.045 | 0.030 | 1.00 | 16.0-18.0 | 10.0-15.0 | 2.00-3.00 | ^ | ^ | ^ |
| TP321 | 0.08 | 2.00 | 0.045 | 0.030 | 1.00 | 17.0-19.0 | 9.0-12.0 | ^ | ^ | ^ | 5C -0,70 |
| TP347 | 0.08 | 2.00 | 0.045 | 0.030 | 1.00 | 17.0-19.0 | 9.0-12.0 | 10C -1.10 | ^ | ||
| Lintho tse bonahalang | Phekolo ea mocheso | Mocheso F (C) Min. | Ho thatafala | |
| Brinell | Rockwell | |||
| TP304 | Tharollo | 1900 (1040) | 192HBW/200HV | 90HRB |
| TP304L | Tharollo | 1900 (1040) | 192HBW/200HV | 90HRB |
| TP316 | Tharollo | 1900(1040) | 192HBW/200HV | 90HRB |
| TP316L | Tharollo | 1900(1040) | 192HBW/200HV | 90HRB |
| TP321 | Tharollo | 1900(1040) F | 192HBW/200HV | 90HRB |
| TP347 | Tharollo | 1900(1040) | 192HBW/200HV | 90HRB |
| OD, inch | OD Tolerance inch(mm) | Mamello ea WT % | Length Tolernace inch(mm) | |
| + | - | |||
| ≤ 1 / 2 | ± 0.005 ( 0.13 ) | ± 15 | 1 / 8 ( 3.2 ) | 0 |
| > 1/2 ~1 1/2 | ± 0.005(0.13) | ± 10 | 1 / 8 (3.2) | 0 |
| > 1 1 / 2 ~< 3 1 / 2 | ± 0.010(0.25) | ± 10 | 3 / 16 (4.8) | 0 |
| > 3 1 / 2 ~< 5 1 / 2 | ± 0.015(0.38) | ± 10 | 3 / 16 (4.8) | 0 |
| > 5 1 / 2 ~< 8 | ± 0.030(0.76) | ± 10 | 3 / 16 (4.8) | 0 |
| 8 ~ <12 | ± 0.040(1.01) | ± 10 | 3 / 16 (4.8) | 0 |
| 12 ~ <14 | ± 0.050(1.26) | ± 10 | 3 / 16 (4.8) | 0 |
White matter hyperintensity (WWH) ke ntho e tloaelehileng e fumanoang ho imaging resonance imaging (MRI) ea boko 'me e tsebahala e bonahatsa lefu la likepe tse nyenyane bokong.Sepheo sa thuto ea rona e ne e le ho batlisisa kamano ea coronary artery calcium (CCA) le WMH le ho hlakisa kamano pakeng tsa WMH le mabaka a kotsi bakeng sa atherosclerosis ho baahi ba bangata ba phelang hantle.Thuto ena ea morao-rao e kenyelelitse batho ba 1337 ba ileng ba etsa MRI ea boko le computed tomography le tlhahlobo ea CAC setsing sa bongaka sa sepetlele sa thuto e phahameng.GVM ea boko e hlalositsoe e le lintlha tsa Fazekas tse fetang lintlha tse 2 ho MRI ea boko.Intracranial arterial stenosis (ICAS) le eona e ile ea hlahlojoa le ho tiisoa ha angiography e bontša ho feta 50% stenosis.Mekhatlo ea mabaka a kotsi, lintlha tsa CAC le ICAS tse nang le boko ba HBG li ile tsa hlahlojoa ho sebelisoa tlhahlobo ea ho fokotsa mekhoa e mengata.Ha ho hlahlojoa mefuta e mengata, lihlopha tse nang le lintlha tse phahameng tsa CAC li bontšitse kamano e eketsehileng le periventricular le khatello ea kelello e tebileng ka mokhoa o itšetlehileng ka tekanyo.Ho ba teng ha ICAS ho ne ho boetse ho amahanngoa haholo le boko ba HBH, 'me har'a mefuta e fapaneng ea meriana, lilemo le khatello ea kelello e ne e le mabaka a ikemetseng a kotsi.Qetellong, ho batho ba phetseng hantle, CAC e ne e amahanngoa haholo le boko ba WMH, e ka fanang ka bopaki ba ho khetholla batho ba kotsing ea boko ba WMH mabapi le lintlha tsa CAC.
White matter hyperintensity (WWH) ke ntho e tloaelehileng e fumanoang ho T2-weighted and fluid-attenuated magnetic resonance imaging (MRI) inversion recovery (FLAIR) tatellano ea boko1,2.Le hoja mokhoa o nepahetseng oa pathophysiological oa HHH o sa tsejoe, ho bontšitsoe hore o amahanngoa le lisosa tsa kotsi bakeng sa lefu la atherosclerosis tse kang botsofali, khatello ea mali, lefu la tsoekere, ho tsuba le botenya, ho fana ka maikutlo a tlatsetso ea mekhoa ea methapo ho nts'etsopele ea HHH3,4,5 ,6.,7,8,9,10.Liphuputso tsa pathological li boetse li bontšitse hore HHH e bakoa ke ho senyeha ha methapo ea mali, kahoo ho tiisa hore HHH ke pontšo ea lefu la lijana tse nyenyane bokong11.Ho feta moo, SHG e bohlokoa haholo ho tsa bongaka kaha e bontšitsoe ho susumetsa liketsahalo le ho tsebahala ha mafu a fapaneng a methapo ea kutlo, ho kenyelletsa ho fokotseha ha kelello, 'dementia', khatello ea maikutlo, khatello ea maikutlo, le stroke12,13,14,15,16,17,18, 19 , 20, 21, 22, 23 .
Coronary calcium assessment (CAC) e nkoa e le tekanyo e loketseng le e ka tšeptjoang ea ho ba le monyetla oa ho bokella motho ho atherosclerosis 'me e bontšitsoe hore e amahanngoa le lefu la ischemic le cranial artery stenosis, hammoho le lefu la pelo24,25.Boloetse ba likepe tse nyane tsa boko bo tsamaisana habonolo le atherosclerosis ea methapo e meholo ea methapo ea kutlo hobane lijana tse nyane tse phunyeletsang tse fanang ka taba e tšoeu li tsoa mothapong o moholo oa basilar.Liphuputso tse ngata li fumane kamano pakeng tsa SHH le mabaka a kotsi bakeng sa atherosclerosis kapa carotid atherosclerosis, leha ho le joalo, ke lithuto tse fokolang feela tse tsepamisitseng maikutlo kamanong pakeng tsa moroalo oa SAS le SHH, 'me lithuto tsena li entsoe feela ho batho ba baholo kapa banna ba 29, 30, 31 .32.
Ka phumaneho e ntseng e eketseha ea neuroimaging lilemong tsa morao tjena, ho ata ho phahameng le bohlokoa ba bongaka ba HHH bo ntse bo tsejoa ka ho eketsehileng e le selelekela sa ho fokotseha ha kelello le liphello tsa stroke19,20,21,22,23.Sepheo sa phuputso ena e ne e le hore, haeba CAC e ka sebelisoa ts'ebetsong ea bongaka ho bolela esale pele kotsi ea HHH, selelekela sa mafu a sa tšoaneng a methapo ea kutlo, e ka ba sesebelisoa se loketseng le se molemo ho khetholla bakuli ba ka ruang molemo ho eona Liphuputso tse ling ka bomong. , joalo ka MRI ea boko19,20,21,22,23.Re ile ra nahana hore palo e kholo ea batho ba phelang hantle ka kakaretso sechabeng, HHH e amana haufi-ufi le moroalo oa CAC, e leng pontšo ea atherosclerosis.Ho feta moo, re ile ra batla ho thusa ho utloisisa mekhoa e thehiloeng ho nts'etsopele ea HHH ka ho khetholla mabaka a kotsi a bophelo bo botle.Kahoo, sepheo se seholo sa thuto ena e ne e le ho batlisisa kamano ea CAC le WMH ho baahi ba phetseng hantle.Taba ea bobeli, sepheo sa thuto ena e ne e le ho hlakisa kamano lipakeng tsa SHG le mabaka a kotsi a atherosclerosis.
Phuputso ena ke phuputso e fapaneng ea ho khutlela morao e thehiloeng ho batho ka kakaretso.Re batlile lipolokelo tsa elektroniki tsa bankakarolo ba ileng ba etsa litlhahlobo tsa bongaka, ho kenyeletsoa MRI ea boko le magnetic resonance angiography (MRA), Gangbuk Samsung Hospital General Medical Centers e Seoul le Suwon pakeng tsa Pherekhong 2016 le Tšitoe 2019. CT) le ho nahana ka boko e le karolo ea tlhahlobo e felletseng ea 'mele, e leng mekhoa e tloaelehileng ea tlhahlobo ea bophelo bo botle Korea.Bakeng sa litšupiso, molao oa Korea o hloka hore basebetsi bohle ba hlahlojoe khafetsa selemo le selemo kapa habeli, kahoo barupeluoa ba bangata ke basebetsi kapa litho tsa malapa a basebetsi ba lik'hamphani tse fapaneng kapa mekhatlo ea mmuso ea lehae.
Ho batho ba 3983, 2646 e ne e sa kenyelletsoa ka mabaka a latelang: a) ho se lumellane le tšebeliso ea tlhahisoleseding ea bongaka bakeng sa merero leha e le efe ea lipatlisiso lethathamong la lipotso tse ikemetseng pele ho tlhahlobo (n = 376);haeba liteko tse pheta-phetoang li ne li etsoa nakong eo (n = 43), batho ba nang le liteko tsa ho pheta-pheta ba ne ba sa kenyelletsoa, 'me litšoantšo tsa CT le boko bo nang le tlhahlobo ea CAC e entsoeng ka letsatsi le le leng kapa ka nako ea morao-rao ea nako e khethiloeng bakeng sa thuto;(c) 'dementia' e tsebahalang, lefu la Parkinson.histori, hydrocephalus, ho buuoa ka boko bo fetileng, hlahala ea boko, lefu la moyamoya, stroke kapa hemorrhage (n = 47);(d) batho ba nang le maqeba a bohlokoa a boko ba fumanoeng ke tlhahlobo ea litšoantšo, ka mohlala, ka lebaka la ho hlajoa ke lefu la pelo (tekanyo e kholo ea bophara ho feta 15 mm) kapa ho tsoa mali a khale a sithabetsang, arteriovenous malformation, kapa neoplastic lesion (n = 46);(e) batho ba nang le MRI kapa MRA ea boleng bo sa lekaneng bakeng sa tlhahlobo ea litšoantšo (n = 2);(f) batho ba sa kang ba etsa CT sekaleng sa CAC (n = 1796);(g) batho ba neng ba se na lintlha tsa linomoro tse hlokahalang bakeng sa tlhahlobo, ho kenyelletsa index ea boima ba 'mele (BMI) le maemo a homocysteine (n = 336).Lethathamo la ho thaotha bankakarolo thutong le bonts'itsoe ho Setšoantšo sa 1.
Kenyelletsa lethathamo la barupeluoa.MRI magnetic resonance imaging, MRA magnetic resonance angiography, periventricular white matter hyperintensity PVWMH, deep white matter hyperintensity DWMH.
Ka hona, lihlooho tsa 1337 (lilemo tse bolelang 51.63 ± 9.20, lilemo tse 20-89, 1157 [86.54%] bakuli ba banna) li kenyelelitsoe thutong ena.Barupeluoa bohle ba ile ba hlahlojoa ka morao ho liphuputso tsa kliniki le tsa radiographic.Thuto ena e entsoe ho latela melao-motheo ea Phatlalatso ea Helsinki 'me e amohetsoe ke Boto ea Tlhahlobo ea Setsi (IRB) ea Gangbuk Samsung Hospital (IRB No. 2020-12-036-006).IRB Sepetleleng sa Kangbuk Samsung e tlohetse tlhoko ea tumello e nang le tsebo ka lebaka la ts'ebeliso ea data e sa tsejoeng le moralo oa boithuto oa morao-rao.Mekhoa eohle ea lipatlisiso e entsoe ho latela litataiso le melaoana e amehang.
Re bokelletse lintlha tsa motho ka mong tsa bongaka tse kenyeletsang bong, lilemo, BMI, systolic le diastolic blood pressure, nalane ea ho tsuba, boikoetliso ba 'mele, tlhahlobo le kalafo ea khatello ea mali, lefu la tsoekere, hyperlipidemia, le lefu la pelo.Ho tsoa lethathamong la lipotso tseo motho a iketsetsang tsona, re bokelletse lintlha tse mabapi le nalane ea motho e mong le e mong oa bongaka le nalane ea ho tsuba, hammoho le hore na ba ne ba lula ba ikoetlisa ka matla nako e fetang metsotso e 10 bonyane makhetlo a 3 ka beke.
Hobane barupeluoa bohle ba ne ba reretsoe ho hlahlojoa Ganbuk Samsung Hospital General Medical Center, liteko tsa laboratori li ile tsa etsoa ka letsatsi le le leng le MRI ea boko le MRA ka mor'a ho itima lijo ka lihora tse 12, 'me lintlha li ne li kenyelletsa glucose, glycated hemoglobin (HbA1c), maemo. kakaretso ea k'holeseterole, LDL cholesterol, HDL cholesterol, triglycerides le homocysteine.
Khatello ea mali ea methapo e ne e hlalosoa e le ho noa hona joale ha lithethefatsi tsa antihypertensive, khatello ea mali ea systolic ≥ 140 mmHg.kapa khatello ea mali ea diastolic ≥ 90 mmHg33.Lefu la tsoekere le ne le hlalosoa e le ts'ebeliso ea hona joale ea lithethefatsi tsa antidiabetic, tsoekere ea mali e potlakileng ≥ 126 mg / dL, kapa HbA1c ≥ 6.5%.Dyslipidaemia e ne e hlalosoa e le tšebeliso ea hona joale ea lithethefatsi tse fokotsang lipid, kakaretso ea k'holeseterole ≥240 mg / dl, k'holeseterole e tlaase-density lipoprotein ≥160 mg / dl, high-density lipoprotein cholesterol <40 mg / dl, kapa triglycerides ≥200 mg / dl35.
Barupeluoa bohle ba ile ba e-ba le MRI ea boko le MRA e nang le mokokotlo oa lihlooho tse robeli tse sebelisang mochine oa 1.5 T MRI (Optima MR360, GE Healthcare, Milwaukee, Wisconsin kapa Signa HDxt, GE Healthcare, Milwaukee, Wisconsin).Protocol ea litšoantšo e ne e e-na le litšoantšo tse boima ba axial T1 (nako ea ho pheta-pheta [TR]/echo nako [TE] = 417–450/9 ms kapa 400–450/10 ms), litšoantšo tse boima ba T2 (TR/TE = 4343–4694 ) ./100-110 ms kapa 4084-4494/95-104 ms), litšoantšo tsa FLAIR (TR/TE = 11000/127-138 ms kapa 8800/128-130 ms) le 3D nako ea ho fofa (TOF) litšoantšo (TR /TE = 28/7 ms kapa 27/3 ms, botenya ba selae = 1.2 mm).Botenya ba selae e ne e le 5 mm bakeng sa liprothokholo tsohle tsa litšoantšo ntle le TOF MRA.
Tekanyo ea periventricular le botebo ba WMH e ile ea lekoa ka thoko ho latela thuto ka 'ngoe ea Fazekas scale1, joalo ka ha ho bonts'itsoe ho Setšoantšo sa Tlatsetso 1 inthaneteng.PVWMH e ile ea fuoa lintlha ka tsela e latelang: 0=ha ho letho, 1=kepisi kapa lesela le tšesaane, 2=halo e boreleli, 3=e sa tloaelehang ea periventricular hyperintensity e fetelang nthong e tšoeu e tebileng.DMH e arotsoe ka tsela e latelang: 0 = ha e eo, 1 = punctate, 2 = liso li qala ho kopana, 3 = libaka tse kholo tsa confluence.Hobane boko ba HBH grade 2 kapa ho feta bo tsejoa bo le bohlokoa ho tsa bongaka hobane bo na le matšoao le tsoelo-pele, re arolelitse bakuli ba nang le lintlha tsa Fazekas tsa 2 le 3 PVBVH le DGBV36,37.
Tlhahlobo ea TOF MRA, e ipapisitseng le mokhoa oa warfarin-aspirin symptomatic intracranial disease (WASID), e hlalosa intracranial artery stenosis (ICAS) e le intracranial artery stenosis e kholo ho feta 50%38.Lijana tse kenyellelitsoeng tlhahlobisong e ne e le mothapo oa ka hare oa carotid ho tloha karolong ea cavernous ho ea karolong ea M2 ea methapo e bohareng ea boko, karolo ea A2 ea mokokotlo oa boko bo ka pele, karolo ea P2 ea mokokotlo oa mokokotlo oa mokokotlo, methapo ea basilar le intracranial. mothapo wa madi.karolo ea lesapo la mokokotlo.
Litlhahlobo tsohle tsa radiological li entsoe ke setsebi sa methapo ea kutlo (JYK), se neng se sa tsebe lintlha tsohle tsa kliniki le tsa laboratori.Ho tšepahala ha tekanyo ea pono pakeng tsa bashebelli ho ile ha hlahlojoa ke radiographer ea bobeli e koetlisitsoeng (JYC) lithutong tse 700 tse khethiloeng ka mokhoa o sa reroang le ka nako ea likhoeli tsa 2 ka mor'a ho bala pele.Lekola ho tšepahala ka hare ho moshebelli.Litlhahlobo tse bonoang tsa PVWMH, DWMH, le ICAS li bonts'itse setsebi se setle sa li-inter-expert (Cohen-weighted kappa: 0.7, 0.81, le 0.67, ka ho latellana; n = 700) le ka hare ho setsebi (Cohen-weighted kappa: 0.92, 0.88, le 0 . 65, ka ho latellana; n = 1339) protocol.
Palo ea CAC e ile ea hlahlojoa ho batho ba ileng ba etsoa CT ho hlahloba CAC nakong ea lilemo tse 5 tsa boko ba MRI le MRA39.Ho batho ba 1,337, ba 686 ba ile ba hlahlojoa boko ka letsatsi le le leng le ba 651 ka letsatsi le leng nakong ea lilemo tse 5.
Litsi tsa Seoul le Suwon li sebelisitse mAc (310 mA × 0.4 s) tube current ka botenya ba 2.5 mm, 400 ms rotation time, 120 kV tube voltage, le 124 modulation ea lethamo e itšetlehileng ka ECG.Ho ea ka Agatston et al.40, CAC e ne e baloa ho tloha methapong e meholo ea 4 ea epicardial coronary arteries (ka ho le letšehali, ka ho le letšehali ka pele ho theoha, ho le letšehali circumflex, le methapo ea pelo e nepahetseng).Setsebi sa CT se ile sa foufatsoa ke tlhahisoleseling efe kapa efe mabapi le taba eo mme palo ea CAC e ile ea khethoa ka bo eona ho sebelisa software ea HEARTBEAT-CS (Philips, Cleveland, OH, USA).Lintlha tsa CAC li arotsoe ka lihlopha tse tharo: 0, 1-100, le> 100.
Litšobotsi tsa motheo li ne li bapisoa pakeng tsa lithuto tse nang le WMH ea boko le ntle le eona ho sebelisa tlhahlobo ea χ2 bakeng sa mefuta-futa ea lihlopha le tlhahlobo ea t-test kapa ea Mann-Whitney bakeng sa mefuta e sa khaotseng, ha ho loketse.Liphetoho tse ajoang ka tloaelo li ile tsa hlahisoa e le ho kheloha ho tloaelehileng ±, ha mefuta e sa abuoang ka tloaelo e ne e hlahisoa e le mefuta e bohareng le ea interquartile.Liphetoho tsa Dummy li ile tsa hlahisoa bakeng sa boleng bo sieo ba mefuta e fapaneng.
Multivariate logistic regression analysis e ile ea etsoa ho bala odds ratios (ORs) le 95% confidence intervals (CIs) ho hlahloba kamano lipakeng tsa boko ba WMH le CAC scores le mabaka a kotsi bakeng sa atherosclerosis.Kaha ho ata ha HHH ho eketseha ka lilemo 'me ho fapana ho ea ka thobalano, litlhahlobo tsohle tse ngata tse entsoeng ho hlahloba likamano pakeng tsa mefuta e meng le HHH18 e lokiselitsoeng lilemo le thobalano.Mokhoa o mong oa ho fokotsa lintho tse ngata o ile oa sebelisoa ho hlahloba hore na lintlha tsa CAC li na le kamano e ikemetseng le boko ba SHG, esita le ka mor'a ho lokisoa bakeng sa mabaka a kotsi a atherosclerosis le ICAS e le lintlha tse ferekanyang tse tlalehiloeng hore li amahanngoa le SHH litlalehong tse fetileng10, 26, 27, 41 .Mohlala oa 1 o ile oa fetoloa bakeng sa lilemo le tekano, Mohlala oa 2 o ile oa fetoloa bakeng sa lilemo, tekano, le mabaka a kotsi bakeng sa lefu la atherosclerosis (BMI, khatello ea kelello, lefu la tsoekere, dyslipidaemia, motho ea tsubang hona joale kapa oa pele, ho ikoetlisa kamehla, histori ea lefu la methapo ea pelo le maemo a cystine).fetotsoe;Mohlala oa 3 o ile oa lokisetsoa lilemo, tekano, mabaka a kotsi bakeng sa atherosclerosis, le boteng ba ICAS.Boteng ba boko ba WMH bo ile ba lekoa ho latela mekhahlelo ea lintlha tsa CAC ho sebelisoa lintlha tsa CAC 0 joalo ka benchmark.
Tlhahlobo ea lipalo-palo e entsoe ho sebelisoa mofuta oa Stata 16.1 (StataCorp, College Station, Texas, USA) le R studio version 3.6.3 (RStudio, Boston, Massachusetts, USA).Maemo a p-a nang le mehatla e 'meli <0.05 a ne a nkuoa e le a bohlokoa ka lipalo.
Litšobotsi tsa motheo tsa batho ba 1337 li bontšoa ho Lethathamo la 1. Nako e bolelang ea barupeluoa, e hakantsoeng ho tloha nakong ea MRI ea boko, e ne e le lilemo tse 51.63 ± 9.20, 'me 86.54% ea batho ba ithutoang e ne e le banna.Lisosa tse ka sehloohong tsa kotsi ea atherosclerosis sehlopheng sena e ne e le ho tsuba hona joale kapa nakong e fetileng (57.82%), e lateloa ke dyslipidemia (51.76%) le khatello ea mali (28.65%).Mabapi le mefuta e fapaneng ea mahlaseli a kotsi, bakuli ba 158 (11.82%) ba ne ba e-na le PVWMH, 148 (11.07%) ba ne ba e-na le DWH, 'me ba 21 (1.57%) ba ne ba e-na le ICAS.Mabapi le lintlha tsa CAC, barupeluoa ba 849 (63.5%) ba ne ba e-na le lintlha tsa CAC tsa 0, 332 (24.83%) ba ne ba e-na le lintlha tse pakeng tsa 0 le 100, 'me 156 (11.67%) ba ne ba e-na le lintlha tse fetang 100.
Ka tlhahlobo e sa fetoheng, lilemo, bong, le mabaka a mangata a kotsi bakeng sa atherosclerosis, ntle le BMI, dyslipidemia, le ho tsuba hona joale kapa nakong e fetileng, li ne li amahanngoa haholo le boteng ba boko ba HHH (p <0.05) (Letlapa la 2).Batho ba nang le PVWMH le DSWH ba ne ba le baholo mme ba na le moroalo o moholo oa khatello ea mali, lefu la tsoekere, nalane ea lefu la methapo ea pelo, CAC, le ICAS ho feta batho ba se nang PVWMH le DSWH.Ka tlhahlobo e sa fetoheng, karolo e phahameng ea basali le lihlooho tsa sehlopha sa WMH ba tlaleha hore ba ikoetlisa kamehla.Bohareng (interquartile range; IQR) CAC e ne e le 62 (IQR 0-269.5) sehlopheng sa PVWMH le 46.5 (IQR 0-192) sehlopheng sa DWM.Kabo ea likarolo tsa CAC ka boteng ba PVWMH le DWH e bonts'oa feiga.2. Karolo ea lihlopha tse nang le lintlha tse phahameng tsa CAC e eketsehile ka tekanyo ea comorbid WMH.
Peresente ea likarolo tsa lintlha tsa CAC tse ipapisitseng le ho ba le PVMWH (a), DWMH (b), le PVWMH kapa DWMH (c).Calcification of coronary arteries of the SAS, white matter hyperintensity SHG, periventricular white matter hyperintensity HVBV, deep white matter hyperintensity SHVH.
Multivariate regression analysis e fetotsoe bakeng sa lilemo (OR 1.13; 95% CI 1.10-1.16; OR 1.11; 95% CI 1.08-1.14) le khatello ea mali (OR 2.29; 95% CI 1.50-3.50, OR 1.03% CI 1.03% .ka ho latellana) ke PVWMH ka mor'a ho fetola lilemo, thobalano, mabaka a kotsi a atherosclerosis (BMI, khatello ea mali, lefu la tsoekere, dyslipidemia, motho ea tsubang hona joale kapa oa pele, boikoetliso, histori ea lefu la methapo ea pelo, le maemo a homocysteine ) le li-predictors tse ikemetseng tsa kliniki tsa DW. ICAS (tsohle p <0.05) (Letlapa la 3).Ho ne ho se na kamano ea bohlokoa pakeng tsa WMH e fetotsoeng le thobalano, BMI, lefu la tsoekere kapa dyslipidemia, histori ea ho tsuba, kapa ho ikoetlisa kamehla.
Esita le ka mor'a ho lokisoa bakeng sa lintlha tse ferekanyang, lihlopha tse nang le lintlha tse phahameng tsa CAC li bontšitse ho eketseha ha setsoalle le boko ba GMI ka mokhoa o itšetlehileng ka tekanyo e bapisoang le lihlopha tsa litšupiso tse nang le lintlha tsa CAC tsa 0. Bakeng sa PVWMH le DWHH, lihlopha tse nang le palo ea CAC e kholo ho feta 100 ( KAPA 5.45; 95% CI 3.11-9.54 kapa 3.66; 95% CI 2.10-6.38) e bontšitse mokhatlo o moholo ho feta lihlopha tse nang le lintlha tsa CAC tsa 0 ho 100 (OR 2.22; 95% CI).1.36–3,61, KAPA 1,59;95% CI 0.98–2.58).Ha ho bapisoa kamano le CAC pakeng tsa lihlopha tsa PVWMH le tsa DWHW, mefuta eohle e meraro ea tlhahlobo ea mefuta e mengata e bontšitse likamano tse phahameng le PVWMH likarolong tse peli tsa lintlha tsa CAC.Ho ba teng ha ICAS ho ile ha boela ha bontša kamano ea bohlokoa le PVWMH (OR 3.97, 95% CI 1.31-12.06) le DSWH (OR 7.11, 95% CI 2.33-21.77).
Li-coefficients tse fapaneng tsa inflation li ne li baloa bakeng sa mehlala eohle ea ho fokotseha ho hlahloba bokhoni ba multicollinearity, 'me ha ho na mathata a mangata a mangata a fumanoeng (Supplementary Table 1 Inthaneteng).
Thutong ena, kotsi ea SHH ea boko e ile ea eketseha ka palo e ntseng e eketseha ea CAC ka mokhoa o itšetlehileng ka tekanyo ea litekanyetso, 'me liphello li ne li le bohlokoa ho latela lipalo-palo ka mor'a hore ho lokisoe lisosa tsa kotsi tsa atherosclerosis.Liphello tsa rona li lumellana le liphuputso tse fetileng tse bontšang kamano pakeng tsa CAC le boko bo sa tloaelehang ba MRI, ho tsoela pele ho tšehetsa mokhatlo oa CAC le cerebral atherosclerosis ea sekepe se senyenyane hammoho le sejana se seholo sa atherosclerosis29,30,31,32.
Hoa thahasellisa hore mefuteng eohle e meraro ea tlhahlobo ea mefuta e mengata, OR bakeng sa lintlha tsa CAC li ne li le holimo hanyenyane sehlopheng sa PVWMH ho feta sa sehlopha sa DWH.Phapang ena e ka 'na ea e-ba ka lebaka la hore ho se tšoane ha mekhoa ea pathophysiological le mabaka a kotsi ho nahanoa pakeng tsa PVWMH le DWH11,42,43.Li-PVWMH li atisa ho ba teng ka mokhoa o ts'oanang ho li-cerebral hemispheres, ho fana ka maikutlo a hore ho na le bothata bo bongata ba perfusion, ha li-DTMHs hangata li na le kabo ea asymmetric, e fana ka maikutlo a hore li bakoa ke bothata bo tebileng ba perfusion.Kaha sebaka sa periventricular se fanoa ke methapo ea methapo ea methapo e telele ea medulla le makala a perforating [45], e kotsing haholo ha mekhoa ea autoregulatory bakeng sa ho boloka cerebral perfusion e sa sebetse e senyehile ke arteriosclerosis kapa lipoid hyalinosis [46, 47, 48, 49].Hypoperfusion le ischemia lia hlaha.Haholo-holo, liphuputso tse 'maloa li bontšitse hore lipontšo tsa tsamaiso ea methapo ea kutlo, e kang khatello ea mali, lefu la tsoekere, le boteng ba aortic atherosclerosis, li amahanngoa haholo le PVWMH50,51,52,53, e tšehetsang seo re se fumaneng hore lintlha tsa CAC, lilemo le methapo ea mali. khatello e phahameng ea mali e ne e e-na le li-OR tse phahameng bakeng sa PVWMH ho feta tsa DWH mefuteng eohle.
Phuputsong ena, boteng ba ICAS bo ne bo amana haufi-ufi le boko ba HHH, e leng sephetho se ka hlalosoang ke taba ea hore stenosis e kholo ea methapo e meholo ea intracranial e fokotsa phallo ea boko ea sebakeng kapa ea libaka, 'me hypoperfusion ena e sa foleng e tlatsetsa ho mafura a hyalinosis, e leng mekhoa ea motheo.ntshetsopele ya WMH 26.54.
Tumellanong le lithuto tse ngata tse fetileng3, 27, 28, 55 e entsoeng ka merabe e sa tšoaneng, thuto ea rona e boetse e bontšitse hore lilemo le khatello ea kelello li ne li ikemetse ebile li amahanngoa haholo le boko ba HBG ka tlhahlobo ea mefuta e mengata.Leha ho le joalo, kamano pakeng tsa HHH le mabaka a mang a kotsi bakeng sa atherosclerosis e bontšitse liphello tse tsoakaneng litlalehong tse fetileng27,28,37,56.Mabaka a liphetho tsena tse fapaneng e ka 'na ea e-ba ka lebaka la ho se tšoane ha batho ba ithutoang, mekhoa ea ho khetholla mabaka a kotsi, kapa mekhoa e sebelisoang ho hlahloba WMH, e hlokang boithuto bo eketsehileng.
Ho lokela ho hlokomeloa mefokolo e mengata ea thuto ena.Taba ea pele, ena ke thuto ea morao-rao ea baahi ba Asia setsing sa bongaka sa monobrand.Ho ka 'na ha e-ba le kotsi ea ho khetha leeme kaha palo e kholo ea barupeluoa ba ne ba le lilemong tsa ho sebetsa,' me ba fetang halofo ea bona e ne e le banna, ka lebaka la litšobotsi tse ikhethang tsa Korea Boroa, tse hlokang hore lik'hamphani li hlahlobe basebetsi ba tsona kamehla.Ho fokotsa leeme lithutong tsa sehlopha, lithuto tsa nako e telele, tsa longitudinal, le tse tlang ho etsahala joalo ka Rotterdam Study57 kapa Framingham Study58 li lokela ho etsoa.Nakong e fetileng, ho bile le litlaleho tse ngata tse sebelisang Thuto ea Rotterdam ho tsepamisa maikutlo kamanong pakeng tsa boko ba SHG le mabaka a sa tšoaneng a kotsi bakeng sa Atherosclerosis Association pakeng tsa lihlopha le lithuto tsa Framingham 4,59,60,61,62,63.Leha ho le joalo, kaha ha ho le e 'ngoe ea liphuputso tse teng tse shebaneng le kamano pakeng tsa SHG le CCA ho baahi ba tloaelehileng, liphetho tsa rona ke tsa bohlokoa ba tleliniki.Ea bobeli, kaha tlhahlobo ea MRI e etsoa ka pono ke litsebi tsa radiology, ho ba le sepheo ho ka 'na ha se ke ha lekana.Leha ho le joalo, re lekile ho hlōla moeli ona ka ho kenyelletsa palo e kholo ea barupeluoa le ho hlalosa lihlooho tse nang le bonyane WMH e itekanetseng kapa e phahameng e le sehlopha se setle.Ho feta moo, re ile ra etsa liteko tsa ho tšepahala ha li-inter-observer le intra-observer, 'me liphetho li bontšitse tumellano e ntle.Ho boetse ho tlalehiloe hore ho na le kamano e phahameng lipakeng tsa mekhoa ea tlhahlobo ea pono e sebelisang sekala sa Fazekas le tlhahlobo ea volumetric e sebelisoang ho lekola sehlopha sa WMH64,65.Ntlha ea boraro, batho ba nang le liso tsa boko ba ne ba qheleloa ka thōko ho sebelisa lethathamo la lipotso tse ikemetseng tse neng li kenyelletsa histori ea bongaka ea nakong e fetileng le tlhahlobo ea litšoantšo tsa batho ba nang le maloetse a mangata 'me ba ka' na ba se ke ba hloekisa batho ba nang le lefu la subclinical.Ho phaella moo, lenaneo la boko ba MRI bakeng sa tlhahlobo ea bophelo bo botle sepetleleng sa rona ha le kenyelle litšoantšo tse ntlafetseng, kahoo ho na le monyetla oa ho lahleheloa ke ho hlahlojoa ha maqeba a boko a ntlafetseng a sa bonahaleng litšoantšong tsa T1-weighted, T2-weighted le FLAIR, le sekhahla sa ho nepahala se phahame.Ha ho bapisoa le ntlafatso ea MRA, boteng ba ICAS bo ile ba nkoa bo le tlase haholo.Ea bone, kaha boholo ba barupeluoa thutong ena ba ne ba tsoa ho baahi ba phetseng hantle 'me ba bangata ba ne ba se na lefu leha e le lefe, karolo ea batho ba tšoeroeng ke ICAS e ne e batla e le nyenyane.
Leha ho le joalo, phuputso ena e kenyelelitse batho ba phetseng hantle ho feta lithuto tse fetileng tse shebaneng le kamano pakeng tsa SHG le SAS, 'me ho ea ka tsebo ea rona, ena ke thuto ea pele e kenyelletsang batho ba baholo ba phelang hantle ntle le ho hlalosa bong kapa lilemo.Meeli ea thuto 31,32.
Bohlokoa ba boko ba WMH le mathata a fapaneng a amanang le methapo ea kutlo a kang 'dementia' le stroke li totobatsoa ka lebaka la keketseho e tsotehang ea ho fumaneha ha litšoantšo tsa boko le nako ea bophelo, empa mafu ana a lula a sa hlōloe.Ho ba teng ha liso tsa HHH bokong ho amahanngoa le ho fokotseha ho hoholo ha kelello, 'dementia', khatello ea maikutlo, le stroke, 'me ho na le bopaki bo ntseng bo eketseha ba hore ho laola maemo a itseng a kotsi a atherosclerosis ho ka thibela HHH12, 13, 14, 15, 16, 17, 18 , 19, 20, 21, 22, 23, 66, 67, 68, 69. Ka hona, liphetho tsa rona li ka fana ka bopaki ba ho hlahloba batho ba kotsing ea boko ba HHH, e leng kotsi ea bohlokoa le selelekela sa mafu a sa tšoaneng a methapo ea kutlo, mabapi le lintlha tsa CAC, ka hona ho khetholla bakuli ba ka ruang molemo ho tsoa lits'ebetsong tse mabifi tsa tlhahlobo le kalafo.hore na CAC e phetha karolo ea bohlokoa le e ikemetseng ho nts'etsopele ea WMH lithutong tsa nako e telele le tse lebelloang tse tsoang libakeng tse fapaneng, lihlopha tsa lilemo le merabe, le matšoao a mang a MRI a lefu la boko ba likepe tse nyenyane le tsona li lokela ho kenyelletsoa bakeng sa kutloisiso e feletseng.
Qetellong, lintlha tsa CAC hammoho le lilemo le khatello ea mali li ne li amahanngoa haholo le boko ba WMH ho batho ba bangata ba phelang hantle.Lintlha tsa CAC ke sesupo sa moroalo oa atherosclerotic mme se na le karolo e ka bang teng ho boleleng esale pele kotsi ea boko ba HHH ts'ebetsong ea bongaka.
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