颅内外动脉粥样硬化性狭窄与脑白质高信号的关系  

Relation of extracranial and intracranial atherosclerotic stenosis with white matter hyperintensities

作　　者：钟婷婷[1] 郁可[1] 霍颖超[1] 陶永[1] 周华东[1] 

机构地区：[1]第三军医大学大坪医院神经内科,重庆400038

出　　处：《中华老年心脑血管病杂志》2015年第12期1282-1285,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨颅内外动脉粥样硬化性狭窄对脑白质高信号（WMH）发生及严重程度的关系。方法连续收集同时完成头颅MRI及头颈部CT血管成像检查且年龄≥60岁患者共617例。评估脑室旁白质高信号（PVWMH）和深部脑白质高信号（DWMH）严重程度;计算颅内外动脉狭窄率及狭窄个数;比较颅内外动脉狭窄对PVWMH和DWMH严重程度的影响并进行logistic回归分析。结果PVWMH及DWMH患者分别与无该病变患者比较,颅内外动脉狭窄患病率明显增高（P〈0.01）。logistic回归分析显示,颅内动脉狭窄与PVWMH（OR=3.01,95%CI：1.75~5.17）和DWMH（OR=2.27,95%CI：1.33~3.89）有显著差异（P〈0.01）。与无动脉狭窄PVWMH评分及DWMH评分比较,颅内动脉狭窄1个、2个及≥3个,颅内外动脉狭窄共存2个及≥3个狭窄显著升高,差异有统计学意义（P〈0.01,P〈0.05）。结论颅内动脉狭窄很可能是WMH的独立危险因素,且其严重程度对WMH的影响较颅外动脉狭窄更加显著。Objective To study the relation of extracranial and intracranial atherosclerotic stenosis with white matter hyperintensities.Methods Six hundred and seventeen patients with their age≥60years who underwent MRI and CTA were included in this study.Their periventricular white matter hyperintensities（PVWMH）and deep white matter hyperintensities（DWMH）were assessed.Effect of extracranial and intracranial atherosclerotic stenosis on PVWMH and DWMH was analyzed by logistic regression analysis.Results The incidence of extracranial and intracranial atherosclerotic stenosis was significantly higher in patients with PVWMH and DWMH than in those without PVWMH and DWMH（P0.01）.Logistic regression analysis showed that intracranial atherosclerotic stenosis was an independent risk factor for PVWMH and DWMH（OR=3.01,95%CI：1.75-5.17,OR=2.27,95%CI：1.33-3.89,P0.01）.The PVWMH and DWMH scores showed 1,2,≥3intracranial atherosclerotic stenoses and 2,≥3extracranial atherosclerotic stenoses,which were higher in patients with PVWMH and DWMH than in those without PVWMH and DWMH（P0.01,P0.05）.Conclusion Intracranial atherosclerotic stenosis is an independent risk factor for WMH.

关 键 词：颅内动脉硬化 脑白质疏松症 磁共振成像 体层摄影术 X线计算机 

分 类 号：R743.1[医药卫生—神经病学与精神病学] R742[医药卫生—临床医学]