急性缺血性卒中患者小脑和脑桥白质病变及其危险因素分析  

Prevalence and Factors Associated with White Matter Lesions of the Cerebellum and the Pons among Patients with Acute Cerebral Infarct

作　　者：高天理[1] 刘春洁[1] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,北京市100029

出　　处：《中国全科医学》2014年第6期615-618,共4页Chinese General Practice

摘　　要：目的探讨急性缺血性卒中患者小脑和脑桥白质病变(WML)发生情况及其危险因素。方法选取2011年10月—2012年10月在我院住院的急性缺血性卒中患者206例,回顾性分析患者的MRI表现,判断是否存在小脑和脑桥WML。并采用多因素Logistic回归分析探讨小脑和脑桥WML的危险因素。结果 206例患者中,65例(31.6%)存在小脑和脑桥WML,其中42例(64.6%)的WML是双侧,39例(60.0%)合并幕上WML。小脑和脑桥WML患者的年龄及高血压、幕上皮质下WML、多发腔隙性脑梗死的发生率高于无小脑和脑桥WML患者(P<0.05);Logistic回归分析显示,幕上皮质下WML〔OR=2.3,95%CI(1.4,7.5)〕和多发腔隙性脑梗死〔OR=2.1,95%CI(1.9,5.6)〕是小脑和脑桥WML的独立影响因素。结论急性缺血性卒中患者中,近1/3的患者存在小脑和脑桥WML;幕上皮质下WML和多发腔隙性脑梗死是小脑和脑桥WML的危险因素。Objective To investigate prevalence and risk factors associated with white matter lesions （WML） of the cerebellum and the pons among patients with acute cerebral infarct. Methods A total of 206 acute cerebral infarct patients who were admitted to our hospital from October 2011 to October 2012, were selected as study subjects, MRI findings were analyzed retrospectively to identify the presence of WML of the cerebellum and the pons. Multiple Logistic regression analysis was used to i- dentify risk factors associated with WML of the cerebellum and the pons. Results Among 206 patients, 65 （31.6%） patients had WML of the cerebellum and the pons, 42 （64. 6% ） patients had bilateral lesions, 39 （60. 0% ） patients also had suprat- entorial WML. Age, prevalences of hypertension, supratentorial infraeortieal WML, multiple lacunar infarction among patients with WML of the cerebellum and the pons were significantly higher than those among patients without WML of the cerebellum and the pons （ P 〈 0.05 ） . According to results of Logistic regression analysis, supratentorial subeortical WML [ OR = 2. 3, 95% CI （ 1. 4, 7. 5） ] and multiple lacunar infarction [ OR = 2. 1, 95% CI （ 1.9, 5. 6 ） 3 were independently related to WML of the cerebellum and the pons. Conclusion WML of the cerebellum and the pons exist in nearly a third of patients with acute cerebral infarct, supratentorial subcortical WML and multiple lacunar infarction were risk factors for WML of the cerebellum and the pons.

关 键 词：卒中 白质病变 脑小血管病 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]