伴有脑白质疏松的腔隙性脑梗死患者危险因素分析  

The clinical analysis of risk factors in lacunar infarction patients with leukoaraiosis

作　　者：沈明[1] 高旭光[1] 

机构地区：[1]北京大学人民医院神经内科,100044

出　　处：《北京医学》2008年第4期221-223,共3页Beijing Medical Journal

摘　　要：目的以有症状的腔隙性脑梗死患者为对象,分析伴有和不伴有脑白质疏松(LA)患者危险因素的差异,探讨LA发生的机制。方法经头颅MRI证实有症状的腔隙性脑梗死患者268例,分为单纯腔隙性梗死组(LI组)和伴有脑白质疏松组(LA组)。对患者的性别、年龄、高血压病史、脑梗死病史等多种危险因素进行单因素分析及Logistic回归分析。结果LI组138例(51.5%),平均年龄(63.4±11.4)岁;LA组130例(48.5%),平均年龄(71.3±8.9)岁,两组比较有显著性差异(P﹤0.01)。两组年龄、冠心病史、高血压病史、既往脑梗死病史、叶酸浓度[(16.1±8.4)ng/ml,(13.1±5.9)ng/ml]和纤维蛋白原水平[(3.0±0.9)g/L,(3.4±0.8)g/L]均有显著性差异。多因素回归分析最终入选模型的变量是年龄、既往脑梗死史、叶酸和高血压病史。结论高龄、高血压病史、脑梗死病史和低血浆叶酸浓度对于有症状的腔隙性脑梗死患者是否伴发LA有独立的提示作用,纤维蛋白原可能通过与其他因素一起在LA的形成中发挥作用。Objective To compare the differences of risk factors between lacunar infarction patients with and without leukoaraiosis（LA）. Methods 268 patients with symptomatic lacunar infarction underwent by MRI scans were divided into two groups （with and without LA）. The lacunar infarctions was verified by DWI sequences and the LA was detected by FLAIR sequences. The risk factors in patients with LA （LA group） were compared with the patients without LA （LI group）. Results There were 138 cases （51.5%） in LI group, with the average age of （63.4±11.4） years old. There were 130 cases in LA group with the average age of （71.3±8.9） years old. The two groups had signigicant difference in age, the history of ischemic stroke, ischemic heart disease and hypertension, the levels of folic acid and fibrinogen. In logistic regression analysis age, history of ischemic stroke and hypertension, folic acid level were included in the model. Conclusions Older age, history of hypertension and ischemic stroke, lower level of plasma folic acid are related to LA in patients with symptomatic lacunar infarction. Fibrinogen has effect on LA but is not an independent risk factor.

关 键 词：脑白质疏松 腔隙性脑梗死 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]