急性缺血性脑卒中患者重度脑白质病变的危险因素分析  

The risk factors of severe white matter lesions in acute ischemic stroke

作　　者：曹林[1] 张美芳[1] 胡旻婧[1] 沈丽华[1] 

机构地区：[1]南通大学附属医院神经内科,江苏南通226000

出　　处：《重庆医学》2016年第11期1526-1527,1530,共3页Chongqing medicine

摘　　要：目的探讨急性缺血性脑卒中患者重度脑白质病变（WML）发生情况及其危险因素。方法入选248例急性缺血性脑卒中患者,调查患者的一般资料,Fazekas量表对WML严重程度评定并根据评定结果分为重度组和非重度组,对比观察两组患者一般资料差异,以重度WML为应变量,将单因素筛选的可能影响因素作为自变量进行多因素Logistic回归分析。结果248例急性缺血性脑卒中患者中发生重度WML 106例,发生率为42.74%;单因素分析发现,重度组年龄显著高于非重度组,合并高血压、糖尿病发生率显著高于非重度组,差异均有统计学意义（P〈0.05）;多因素Logistic回归分析发现,年龄（OR=4.116,95%CI：1.816~6.454,P=0.000）、高血压（OR=1.462,95%CI：0.842~1.946,P=0.026）和糖尿病（OR=1.157,95%CI：0.698~1.673,P=0.038）是急性缺血性脑卒中患者发生重度WML的独立危险因素。结论急性缺血性脑卒中患者重度WML发生率较高,临床要对高龄及合并高血压、糖尿病等高危人群采取针对性预防措施,以降低重度WML发生。Objective To investigate the incidence of white matter lesions（WML）in acute ischemic stroke,and to analyze its the risk factors.Methods Totally 248 cases of acute ischemic stroke patients were selected,patients′general information were investigated,the WML severity with Fazekas rating scale were evaluated and patients were divided into severe group and no severe group according to the results,the differences of general information between two groups were compared,the severe WML was set as dependent variable,the risk factors were ananlzed by multiariable Logistic regression analysis.Results There were 106 cases severe WML patients among 248 cases acute ischemic stroke,the incidence was 42.74%;single factor analysis found that the age in severe group was significantly higher than non severe group,the incidence of hypertension,diabetes in severe group was significantly higher than non severe group,the difference was statistical significance（P〈0.05）;multiariable Logistic regression analysis showed that age（OR=4.116,95%CI：1.816-6.454,P=0.000）,hypertension（OR=1.462,95%CI：0.842-1.946,P=0.026）and diabetes（OR=1.157,95%CI：0.698-1.673,P=0.038）were the independent risk factors of severe WML in acute ischemic stroke.Conclusion The incidence of severe WML in acute ischemic stroke patients is high,we need to targeted prevention measures on older age,hypertension,diabetes mellitus patients to reduce severe WML occurred.

关 键 词：缺血性脑卒中 脑白质病变 严重程度 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]