摘要
目的探讨有、无高血压的急性脑梗死患者中脑内微出血(cerebral microbleeds,CMBs)的危险因素和影像学上分布特点的不同。方法连续性收集急性脑梗死患者,进行磁共振扫描,包括T1、T2加权相以及梯度回波序列(gradient-echoT2*,GRE-T2*)。分析患者临床特点、MRI上脑白质病变的严重程度和CMBs病灶的分布特点。结果共入选998例急性脑梗死患者,CMBs发生于273例患者,其中62例无高血压病史。在无高血压病史的急性脑梗死患者中CMBs发生率为18.5%(62/335),低于有高血压病史的急性脑梗死患者(211/663,31.8%,P<0.0001)。无高血压患者的CMBs局限于皮层和皮层下者占40.3%(25/62),高于有高血压的患者(20.4%,43/211,P=0.001)。脑白质病变的严重程度,入院时收缩压是无高血压病史急性脑梗死患者发生CMBs的独立危险因素。结论有高血压和无高血压的急性脑梗死患者CMBs分布部位有所不同,后者更多地集中于皮层和皮层下。控制血压在有、无高血压病史的CMBs患者均必要。
Objective To investigate the differences in risk factors and distribution between cerebral microbleeds （CMBs） with and without hypertension. Methods We examined consecutive acute ischemic stroke patients who were admitted to a general regional hospital with standardized MRI protocol, including conventional T1 , T2 and gradient-echo T2 ＊ techniques. Clinical and imaging characteristics including severity of white matter changes and distribution characteristics of CMBs were collected among all the patients. Results Nine hundred and ninety-eight patients were examined. CMBs were detected in 273 patients （273/998, 27. 3% ）, among which 62 were found without hypertension （62/273, 22. 7% ）. The incidence of CMBs among ischemic stroke patients without hypertension （62/335, 18.5% ） was significantly lower than that in patients with hypertension （ 211/663, 31.8 % , P 〈 0. 0001 ）. The location of CMBs among patients without hypertension was limited in cortical-subcortical region in 40. 3% （25/62） , much more than that in patients with hypertension （20. 4% , 43/211, P = 0. 001 ）. For the ischemic stroke patients without hypertension, severity of WMC and systolic blood pressure on admission were found as independent predictors for CMBs. Conclusions The distribution of CMBs in acute ischemic stroke patients without hypertension were more frequently located in the cortical-subcortical region. Controlling of blood pressure should be important in both groups.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2009年第10期594-597,共4页
Chinese Journal of Nervous and Mental Diseases
基金
教育部博士点新教师基金(编号:20070558240)
