经头部CT扫描检出的无症状腔隙性脑梗死与有症状非腔隙性脑梗死的危险因素比较分析  

Respective risk factors of asymptomatic lacunar infaction diagnosed by computed tomography alone and the symptomatic nonlacunar infaction as well as their differences

作　　者：胡洪涛[1] 张振馨[1] 高山[1] 温洪波[1] 王子时[2] 肖新华[3] 刘爱民 徐涛[5] 

机构地区：[1]中国医学科学院北京协和医院神经内科,北京100730 [2]中国医学科学院北京协和医院心内科,北京100730 [3]中国医学科学院北京协和医院内分泌科,北京100730 [4]中国医学科学院北京协和医院病案科,北京100730 [5]中国医学科学院基础医学研究所流行病与统计学教研室,北京100730

出　　处：《中风与神经疾病杂志》2009年第3期355-358,共4页Journal of Apoplexy and Nervous Diseases

基　　金：美国国立卫生研究院-老龄研究所(NIH-NIA)基金资助项目(P015P01AG17937-03);美国中华医学基金会项目(99-699)

摘　　要：目的探讨经头CT扫描检出的无症状腔隙性脑梗死与有症状非腔隙性脑梗死两病例组的危险因素以及危险因素在两病例组间分布的差异。方法对一个有2085例的回顾性出生队列研究人群中所检出的52例有症状非腔隙性脑梗死、49例无症状腔隙性脑梗死分别与1908例非脑血管病对照组进行危险因素的单因素及多因素分析,然后在两病例组间进行危险因素的比较分析;以及两病例组间危险因素数量的比较分析。结果Logis-tic多元回归发现年龄、性别、糖尿病、酗酒、卒中家族史、颅内动脉狭窄是有症状非腔隙性脑梗死的独立危险因素,而年龄、高血压、吸烟是无症状腔隙性脑梗死的独立危险因素。两组间比较显示糖尿病、颅内动脉狭窄在两病例间分布的差异有统计学意义(P值分别为0.005、0.002)。有症状非腔隙性脑梗死组的危险因素数量多于无症状腔隙性脑梗死组(P=0.009)。结论有症状非腔隙性脑梗死与无症状性脑梗死危险因素存在差异,血管机制可能也有不同,糖尿病和颅内动脉狭窄更多见于有症状非腔隙性脑梗死病例组。Objective To investigate the respective risk factors of the symptomatic nonlacunar in/action and the asymptomatic lacunar in/action diagnosed by brain scan of computed tomography alone as well as their differences. Methods 52 symptomatic nonlacunar infaction patients and 49 asymptomatic lacunar infaction patients diagnosed by brain scan of computed tomography alone were found from a sample for retrospective birth cohort study. χ^2 - test, t - test and Logistic regression analysis were used for determing the risk factors for each disease when comparing to the contrast group of 1908 who hadnt suffered form cerebrovascular disease respectively. Each risk factor and the amount of risk factors for the two disease were compared between the 52 symptomatic nonlacunar in/action patients and 49 asymptomatic lacunar in/action patients. Results Age, sex, diabetes mellitus, drinking, family history of stroke and the stenosis of intracrianial artery were the independent predictors of the symptomatic nonlacunar in/action; age, hypertension, smoking were the independent predictors of asymptomatie lacunar in/action. Both the rate of diabetes mellitus （ cerebral in/action 43.1% vs asymptomatic lacunar infaction 16.6% ） and stenosis of intracrianial artery （45.4% vs 15.2% ） were higher in patients with the symptomatic non-lacunar infaction than those with asymptomatic lacunar in/action. Patients with symptomatic nonlaeunar infaction had a sig- nificant increase in the amount of the risk factors than those with asymptomatic lacunar in/action. Conclusion There may have different distribution of the risk factors and different vascular mechanism between the symptomatic nonlacunar in/action and asymptomatic lacunar in/action. Diabetes mellitus and the stenosis of intracrianial artery more commonlg exist in the patients with the symptomatic nonlacunar infarction.

关 键 词：无症状性腔隙性脑梗死 有症状非腔隙性脑梗死 危险因素 比较研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]