摘要
目的探讨脑梗死患者脑白质病变(white matter lesions,WML)患病情况及其危险因素。方法采用多中心横断面研究和病例一病例对照研究。收集全国12家医院2004年5月至12月连续就诊的1～6个月内脑梗死患者720例的临床资料。分别对头 MRI 显示的脑梗死部位、大小、血管分布、血管类型做出判断,用年龄相关性白质改变评分法(Age-Related White Matter Changes Scales,ARWMC)测量脑白质病变,阅片者不了解患者的临床资料。采用 Logistic 回归检验独立危险因素。结果 MRI 图像质量完好700例[平均年龄(59.93±9.86)岁,男/女为481/219],WML 患病率77.4%,随年龄增长患病率和病变严重程度增加。额叶病变最多,程度最重。Logistic 回归显示高龄(OR 1.09,95%CI1.067～1.114)、舒张压升高(OR 1.039,95%CI1.018～1.06)、基底节梗死(OR2.244,95%CI1.609～3.708)与 WML 存在独立相关。结论脑梗死患者 WML 普遍存在。病变以额叶最明显。高龄、舒张压升高、基底节梗死是发生 WML 的独立危险因素。
Objective To evaluate the prevalence and risk factors of cerebral white matter lesions （WML） in ischemic stroke patients. Methods Multicenter, cross-sectional and case-control study was carried out among consecutive 720 patients with cerebral infarction from 12 hospitals national wide for vascular risk factors. MRI scans were blindly reviewed to determine manifestation of infarction lesions and rate the WML load using the Age-Related White Matter Changes Scales. Logistic regressions were applied to analyze related independent influencing factors. Results Of the 700 participants with high resolution brain scans （mean age （59. 93 ± 9. 86 ） years, M/F 481/219 ） , WML presented in 77.4%, the prevalence and severity of WML increasing with age, similarly between men and women. The frontal lobes were the most severely affected by WML compared to other brain regions. Logistic regression analysis identified advanced age（OR 1.09, 95%CI 1. 067-1. 114）, higher diastolic blood pressure（OR 1. 039,95% CI 1. 018-1.06） and basal ganglia infarction （ OR 2. 244, 95% CI 1. 609-3.708 ） as being significantly and independently associated with presence of WML. Conclusion Our study confirms that the presence of WML is common in ischemic stroke patients, and is significantly associated with age, higher diastolic blood pressure and basal ganglia infarction.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2007年第3期182-186,共5页
Chinese Journal of Neurology
关键词
脑梗塞
脑损害
慢性
脑缺血
危险因素
Brain infarction
Brain damage, chronic
Brain ischemia
Risk factors
