缺血性脑血管病患者脑白质病变的危险因素探讨：417例回顾性分析  

Risk factors for incidence of white matter lesion in patients with ischemic cerebrovascular diseases: a retrospective analysis of 417 cases

作　　者：石文磊[1,2] 董艳娟[3] 丁继朝 靳延华 张微微[1] 黄勇华[1] 

机构地区：[1]北京军区总医院神经内科,北京100700 [2]白求恩国际和平医院神经内科,石家庄050082 [3]北京军区总医院干部病房三科,北京100700 [4]廊坊长征医院神经内二科,河北廊坊065000

出　　处：《解放军医学杂志》2016年第5期401-406,共6页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金面上项目(81171100);北京军区总医院创新基金(2015-LC-02)~~

摘　　要：目的分析脑白质病变(WMLs)的危险因素,尤其是高血压、高血糖、高血脂、吸烟等脑血管病与WMLs发生的相关性。方法收集北京军区总医院神经内科417例患者的头颅核磁共振(MRI)检查并给予脑白质病变评分,收集相关临床资料。采用logistic回归分析其独立危险因素。结果多因素有序logistic回归分析显示:年龄(P=0.000)、高血压程度(P=0.007)、同型半胱氨酸(P=0.010)、糖尿病患病时间10年以内(P=0.033)、吸烟40年以上(P=0.003)是WMLs的独立危险因素。年龄(P=0.006)、高血压程度(P=0.028)、吸烟史(P=0.000)是缺血性脑血管病患者WMLs的独立危险因素。结论年龄、同型半胱氨酸值、高血压等级是影响WMLs程度的独立危险因素(P<0.05);年龄越大,高血压程度越重,同型半胱氨酸值越高的患者WMLs程度越重;年龄越大,高血压程度越重,吸烟40年以上者吸烟时间越长的缺血性脑血管病患者WMLs程度越重。Objective To study the risk factors of white matter lesions（WMLs）, especially on the correlation of WMLs incidence with those well known risk factors for cerebrovascular disease（hypertension, hyperglycemia, hyperlipemia and smoking）. Methods Four hundred and seventeen consecutive inpatients in Neurology Department of our hospital were enrolled who had undergone brain MRI. Detailed clinical history, relevant data and the Fazekas scores of WMLs were collected. Logistic regression was used to analyze the independent risk factors. Results Age（P=0.000）, homocysteine level（P=0.010）, grade of hypertension（P=0.007）, patients with diabetes for less than 10 years（P=0.033） and smoking more than 40 years（P=0.003） were correlated with WMLs. In the group of patients with ischemic cerebrovascular disease, the independent risk factors of WMLs are Age（P=0.006）, smoking（P=0.000） and grade of hypertension（P=0.028）. Conclusions Age, homocysteine level and grade of hypertension are independently correlated with WMLs. Age, smoking and grade of hypertension are the independent risk factors for the patients with WMLs and ischemic cerebrovascular disease.

关 键 词：脑白质病变 危险因素 小血管病 

分 类 号：R743.1[医药卫生—神经病学与精神病学]