老年脑梗死患者发生不同位置脑白质病变的危险因素分析  

Analysis of risk factors of different locational white matter changes in elderly patients with cerebral infarction

作　　者：刘千朔[1] 李静[1] 周环[1] 田沈[1] 高连波[1] 

机构地区：[1]中国医科大学附属第四医院神经内科,沈阳110032

出　　处：《中国医师杂志》2015年第11期1643-1646,共4页Journal of Chinese Physician

基　　金：辽宁省科学技术计划资助项目（2013225049）

摘　　要：目的 探求老年脑梗死不同解剖位置的脑白质病变的危险因素.方法 收集在中国医科大学附属第四医院以脑梗死为诊断住院、年龄60～ 85岁、行头核磁共振检查[包括液体衰减反转恢复序列（FLAIR）、T1、T2]的病例,通过Fazekas scale评分将侧脑室旁脑白质病变（PVWMCs）和深部白质病变（DWMCs）分开评分,同时对患者的既往用药史、内科系统及神经系统查体、血常规、血脂检查、每日晨起后静息血压的测量进行登记.运用单因素分析筛选出对脑白质改变有影响的危险因素,再分别对PVWMCs和DWMCs进行等级多因素Logistic回归分析.结果 PVWMCs和DWMCs存在明显的年龄差异（P＜0.05）,且危险程度与年龄增长相关.高血压是PVWMCs独立危险因素,而不是DWMCs的独立危险因素.结论 PVWMC和DWMCs的危险因素不尽相同,应积极控制危险因素从而减少WMC对老年人所产生的危害.Objective To explore risk factors of different locational leukoaraiosis in elderly patients with cerebral infarction.Methods Patients were collected who aged 60 to 85 with cerebral infarctions came to the Fourth Affiliated Hospital of China Medical University and took cerebral magnetic resonance imaging （MRI） [fluid-attenuated inversion recovery （FLAIR）, T1, and T2].The patients were divided into periventricular white matter changes （PVWMCs） and deep white matter changes （DWMCs）, and scored by Fazekas scale, respectively.We registered past medical history, medical systems and neurological examination, blood lipids, regular blood test, and resting blood pressure measurements in the morning.Univariate analysis was used to choose risk factors which ~fected white matter changes.After that, rank multivariate logistic regression analysis was used to test risk factors of PVWMCs and DWMCs, respectively.Results There were significant age differences in both PVWMCs and DWMCs, the degree of risk was associated with age.Conclusions PVWMCs and DWMCs risk factors vary, and we should take control of risk factors actively for the elderly in order to reduce the harm arising from WMC.

关 键 词：脑梗死/并发症 脑白质病 进行性多灶性 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]