摘要
目的探讨无症状脑梗死（silentbraininfarct，SBI）的危险因素和影像学特点。方法以门诊SBI患者为研究对象，有症状非腔隙性脑梗死患者纳入对照组，比较两组危险因素和神经影像学特征。结果在145例SBI患者中，133例（91．72％）存在≥2个病灶，主要见于半卵圆中心（73．10％）。单部位SBI组合并白质病变的患者比例（41．67％对73．68％,x^2=5．484，P=0．019）显著低于多部位SBI组。与SBI患者相比，有症状非腔隙性脑梗死患者年龄更大[（72．42±11．79）岁对（67．03±12．04）岁；t=3．545，P=0．000]，男性（63．55％对46．2l％；x^2=7．447，P=0．006）、高血压（80．37％对64．14％；x^2=7．887，P=0．005）和心房颤动（31．78％对8．97％；x^2=21．113，P=0．000）构成比以及空腹血糖[（6．09±1．23）mmol／L对（5．654-1．18）mmol／L；t：2．863，P=0．005]、总胆固醇[（5．534-0．74）mmol／L对（5．274-0．90）mmol／L；t=2．554，P=0．011]、三酰甘油[（1．894-0．20）mmol／L对（1．774-0．18）mmol／L；t=4．910，P=0．000）]和同型半胱氨酸[（14．88±4．97）mmol／L对（11．94±4．61）mmol／L；t=4．432，P=0．000]水平更高，但脂蛋白（a）更低[（0．18±0．06）扎对（0．27±0．18）gm；t=-5．489，P=0．000]。SBI患者多有2或3个部位病灶（分别为33．8％和43．5％）；而有症状非腔隙性脑梗死患者多有1或2个（分别66．4％和27．1％）部位病灶（P〈0．001）。多变量logistic回归分析显示，仅脂蛋白（a）为SBI的独立危险因素（优势比5．988，95％可信区间2．421～14．706；P=0．000）。结论SBI虽然与有症状非腔隙性脑梗死有着多种共同的常见危险因素，但动脉粥样硬化性危险因素较少，且多部位病灶更多见。
Objective To explore the risk factors and imaging features of silent brain infarction （SBI）. Methods The patient with SBI from the clinic were enrolled in the study, and the patients with symptomatic non-lacunar infarction served as controls. The risk factors and imaging features of both groups were compared. Results Among 145 patients with SBI, 133 （91.72%） had two or more lesions, mainly in the centrum semiovale （73.10%）. The proportion of patients with white matter lesions in the group of SBI in a single location was significantly lower than that in the group of SBI in multiple locations （41.67% vs. 73.68% ;X2 = 5. 484, P = 0. 019）. Compared to the patients with SBI, the age in patents with symptomatic non-lactmar infarction was older （72. 42 ± 11.79 vs. 67.03 ± 12. 04 years; t = 3.545, P = 0. 000）, the proportions of male （63.55% vs. 46. 21% ;X2 = 7. 447, P = 0. 006）, hypertension （80. 37% vs. 64. 14% ; X2 = 7. 887, P = 0. 005） and atrial fibrillation （31.78% vs. 8. 97%, X2 = 21. 113, P = 0. 000）, as well as the levels of fasting glucose （6. 09 ±1.23 mmol/Lvs. 5.65 ± 1.18 mmol/L; t = 2. 863, P = 0. 005）, total cholesterol （5.53 ± 0. 74 mmol/L vs.5.27 ±0. 90 mmol/L; t =2. 554, P = 0. 011）, triglycerides （1.89 ±0. 20 mmol/L vs. 1.77 ± 0. 18 mmol/L; t = 4. 910, P =0. 000） and homocysteine （1 4. 88 ±4. 97 mmol/L vs. 11.94 ±4. 61 mmol/L; t =4. 432, P =0. 000） were hiher. However, the lipoprotein （a） level was lower （0. 18 ±0. 06 g/L vs. 0. 27 ±0. 18 g/L; t = -5. 489, P =0. 000）. Among patients with SB1, 33.8% and 43.5% had lesions in two and three locations, respectively; among patients with symptomatic non-lacunar infarction, 66. 4% and 27. 1% had lesions in a single location and two locations, respectively （P 〈 0. 001）. Multivariate logistic regression analysis showed that lipoprotein （a） was the independent risk factor for SBI （odds ratio 5. 988, 95% confidence interval 2. 421 - 14. 706; P = 0, 000）. Conclusions Although they shared a variety of common risk factors, patients with SBI had less atherosclerotic risk factors than those with symptomatic non-lacunar infarction. Most patients with SBI had lesions in multiple locations.
出处
《国际脑血管病杂志》
北大核心
2012年第11期834-838,共5页
International Journal of Cerebrovascular Diseases
关键词
脑梗死
危险因素
磁共振成像
Cerebral Infarction
Risk Factors
Magnetic Resonance Imaging
