成年烟雾病患者脑微出血的初步研究  

A preliminary study of cerebral microbleeds in adult patients with moyamoya disease

作　　者：孙文[1] 刘文华[1] 袁翠萍[2] 杨松[3] 黄显军[1] 倪冠中[1] 朱双根[1] 范进[1] 刘新峰[1] 

机构地区：[1]南京大学医学院临床学院,南京军区南京总医院神经内科,210002 [2]南京大学医学院临床学院,南京军区南京总医院影像科,210002 [3]常州市第一人民医院神经内科,213003

出　　处：《国际脑血管病杂志》2010年第9期641-645,共5页International Journal of Cerebrovascular Diseases

基　　金：基金项目：国家自然科学基金（30870847）;南京军区“十一五”重点课题（082026）

摘　　要：目的 探讨中国成人烟雾病患者脑微出血（cerebral microbleed,CMB）发生率、分布方式和影响因素.方法 连续纳入南京卒中登记系统中的30例经数字减影脑血管造影确诊的成年烟雾病患者,且均行3.0T磁共振常规序列和磁敏感加权成像检查.收集既往病史、收缩压、舒张压、平均动脉压和白质病变等临床资料,检测空腹血糖水平和纤维蛋白原含量.分析烟雾病患者CMB病灶数量、分布信息及其与各种临床参数的关系.结果 30例入组对象中有10例患者的11侧半球共检出14处CMB,病灶分布以脑深部区域（71.4%）为主,尤以侧脑室旁白质（50.0%）多见.CMB阳性组年龄、性别、出血症状、血压、白质病变和血浆纤维蛋白原含量均与CMB阴性组无显著差异,而前组空腹血糖水平显著高于后组[（8.0±4.1）mmol/L对（4.8±0.4）mmol/L,P=0.035].多因素回归分析显示,空腹血糖水平升高是成年烟雾病患者发生CMB的独立危险因素（OR=10.992,95% CI1.325～91.218 P=0.026）.结论 国内成人烟雾病患者的CMB病灶以深部区域,尤其是侧脑室旁白质好发,空腹血糖水平可能影响烟雾病患者的CMB发生率.Objective To investigate the incidence,distribution patterns,and influencing factors of cerebral microbleed （CMB） in Chinese adult patients with moyamoya disease.Methods Thirty consecutive patients with moyamoya disease confirmed by digital subtraction angiography from the Nanking Stroke Registry Program were included.All patients performed conventional MRI sequences （3.0 T） and susceptibility-weighted imaging.The clinical data,such as medical history,systolic blood pressure,diastolic blood pressure,mean arterial pressure,and white matter lesions were collected.Their fasting blood glucose levels and fibrinogen levels were detected.The numbers of CMB lesion,distribution information,and their relationship with various clinical parameters in patients with moyamoya disease were analyzed.Results Among the 30 subjects included,14 CMBs were detected in 10 patients from 11 hemispheres.The distribution of the lesions was mainly in deep brains （71.4%）,especially in the periventricular white matter （50.0%）.There was no statistical difference in age,gender,hemorrhage symptoms,blood pressure,white mater lesions,and plasma fibrinogen levels between the CMB positive group and CMB negative group.However,the fasting blood glucose levels in the former was significantly higher than those in the latter （8.0 ± 4.1 mmol/Lvs.4.8 ± 0.4 mmol/L P =0.035）.Multivariate regression analysis showed that the increased fasting blood glucose level was an independent risk factor for the occurrence of CMBs in adult patients with moyamoya disease （OR = 10.992,95% CI 1.325-91.218 P=0.026）.Conclusions The CMB lesions are susceptible to Chinese adult patients with moyamoya disease in deep brains,especially in the periventricular white matter.The fasting blood glucose level may influence the incidence of CMBs in patients with moyamoya disease.

关 键 词：烟雾病 脑出血 危险因素 成年人 

分 类 号：R743.3[医药卫生—神经病学与精神病学]