影响急性大动脉粥样硬化性脑梗死患者脑微出血严重程度的危险因素分析  

Analysis of risk factors for affecting the severity of cerebral microbleeds in patients with acute ischemic stroke of large-artery atherosclerosis

作　　者：时建铨[1] 蒋腾[1] 赵红东[1] 田有勇[1] 周俊山[1] 

机构地区：[1]南京医科大学附属南京医院神经内科,江苏南京210006

出　　处：《中风与神经疾病杂志》2016年第6期509-512,共4页Journal of Apoplexy and Nervous Diseases

基　　金：国家自然科学基金(No.81500916)

摘　　要：目的探讨影响急性大动脉粥样硬化性脑梗死患者脑微出血(CMBs)严重程度的危险因素。方法收集2013年7月-2015年1月南京医科大学附属南京医院神经内科住院的TOAST分型为大动脉粥样硬化性的急性脑梗死患者112例,经磁共振磁敏感加权成像(SWI)证实有CMBs的患者56例。根据SWI上CMBs的病灶数,分为1级组9例,2级组28例,3级组19例。收集各组患者病史、一般临床资料、血生化结果及头部MRI,对两组资料进行单因素分析和相关性分析。结果单因素分析结果显示,脑微出血严重程度随着甘油三酯水平的增高而降低,随着同型半胱氨酸水平的增高而增高,随着尿酸水平的增高而增高,随着深部白质高信号Fazekas’s分级的增高而增高,3组间差异有统计学意义(P<0.05)。Spearman秩相关分析显示,脑微出血严重程度与甘油三酯水平呈负相关(r=-0.443,P=0.001);与尿酸水平、同型半胱氨酸水平及深部白质高信号Fazekas’s分级呈正相关(r=0.325,P=0.015;r=0.491,P=0.001;r=0.334,P=0.009)。结论甘油三酯、尿酸、同型半胱氨酸水平及深部白质高信号Fazekas’s分级与急性大动脉粥样硬化性脑梗死患者CMBs的严重程度相关。Objective To investigate the risk factor for affecting the severity of cerebral microbleeds in patients with acute ischemic stroke of large-artery atherosclerosis. Methods 112 patients with acute ischemic stroke of large-artery atherosclerosis admitted from July 2013 to January 2014 in Nanjing First Hospital Affiliated to Nanjing Medical University were enrolled. 56 patients with CMBs were confirmed by MRI magnetic sensitive weighted imaging（ SWI）. According to the number of CMBs on SWI,they were divided into three groups（ mild group,moderate group and severe group）. The history,general clinical data,serum biochemical results and MRI in all groups were enrolled. All the data were analyzed by the univariate analysis and correlation analysis. Results The results of univariate analysis showed that the severity of CMBs decreased with the level of triglyceride,while increased with the level of uric acid（ UA）,the level of serum homocysteine（ Hcy） and the severity of deep white matter hyperintensities（ DWMH）. There were statistically significant among the three groups（ P 〈0. 05）. Spearman correlation analysis showed that the severity of CMBs was negatively correlated with the level of triglyceride（ r =- 0. 443,P = 0. 001）,while positively correlated with the level of uric acid,the level of Hcy and the severity of DWMH（ r = 0. 325,P = 0. 015; r = 0. 491,P = 0. 001; r = 0. 334,P = 0. 009）. Conclusion The level of triglyceride,UA and Hcy and the Fazekas＇ s scale score of DWMH are correlated with the severity of CMBs.

关 键 词：脑梗死 大动脉粥样硬化性 脑微出血 甘油三酯 尿酸 同型半胱氨酸血 深部白质高信号 

分 类 号：R743.34[医药卫生—神经病学与精神病学]