腔隙性脑梗死患者颅内动脉狭窄与脑白质病变发生的关系  

The relationship between intracranial artery stenosis and white matter lesions in patients with lacunar infarcts

作　　者：陶永[1] 霍颖超[2] 符晓艳[2] 王羚入[2] 朱洁[2] 周华东[2] Tao Yong Huo Yingchao Fu Xiaoyan Wang Lingru Zhu Jie Zhou Huadong(Postgraduate School, Bengbu Medical College, Bengbu 233030, Chin)

机构地区：[1]蚌埠医学院研究生部,安徽省蚌埠市233030 [2]第三军医大学大坪医院神经内科

出　　处：《中华解剖与临床杂志》2016年第5期391-396,共6页Chinese Journal of Anatomy and Clinics

基　　金：国家自然科学基金（81000507）

摘　　要：目的：探讨腔隙性脑梗死患者颅内各动脉狭窄与脑白质病变（WML）发生之间的关系。方法回顾性分析2015年1月—2016年3月在第三军医大学大坪医院神经内科住院的279例腔隙性脑梗死患者的临床资料,其中男122例,女157例,平均年龄（66.2±7.9）岁。采用头颅 MRI评估有无 WML 并进行分组：WML 组164例、无 WML 组115例。应用64排螺旋 CT 进行颅内血管造影检查,并参照症状性颅内动脉疾病华法林-阿司匹林研究方法评估颅内动脉狭窄率（管径狭窄率≥50%诊断成立）。 logistic 回归分析腔隙性脑梗死患者颅内各动脉狭窄与 WML 发生的关系。结果279例腔隙性脑梗死患者中,颅内动脉狭窄68例（24.3%）,其中 WML 组有51例、无 WML 组有17例。与无 WML 组患者比较, WML 组平均年龄更大,高血压、糖尿病、冠心病、既往卒中史、颅内动脉狭窄患病率更高（P 值均〈0.05）。 WML 组大脑中动脉狭窄的发生率为16.5%（27/164）,较无WML 组的7.0%（8/115）更高（χ^2=5.568,P 〈0.05）。在调整了年龄、高血压、糖尿病、冠心病、既往卒中史这些危险因素的影响后,logistic 回归显示腔隙性脑梗死患者大脑中动脉狭窄与 WML 发生风险有关（OR =2.13,95% CI 1.18~3.25,P 〈0.05）。结论腔隙性脑梗死患者大脑中动脉狭窄可能是促进 WML 发生的危险因素。Objective To investigate the relationship between intracranial artery stenosis and white matter lesions（ WML） in patients with lacunar infarcts. Methods From January 2015 to March 2016, clinical data of 279 patients who had the lacunar infarcts in the Neurology Department of Daping Hospital of Third Military Medical University were retrospectively analyzed, including 122 males and 157 females with an average of （66. 2 ± 7. 9） years. Using MRI to determine the diagnosis of WML and divide into two groups： WML group （164 patients） and without WML group （115 patients）. The application of 64 slice spiral CT to assess intracranial vascular. The assessment of intracranial artery stenosis refer to the research methods of symptoms of intracranial artery disease warfarin aspirin （ the diagnosis was established if the stenosis rate was more than or equal to 50% ）. Multivariate logistic regression analyses were performed to examine the association between different intracranial artery stenosis and white matter lesions in patients with lacunar infarcts. Results Among 279 patients with lacunar infarcts in the study. The prevalence of intracranial arterial stenosis 68 （24. 3% ） patients including 51 patients of WML group and 17 patients without WML group. The patients in lacunar infarcts with WML group had a higher average age, and the mobidity of hypertension, diabetes, coronary heart disease, prior stroke, intracranial arterial stenosis was significantly higher compared with those in lacunar cerebral infarction without WML group（all P values 〈0. 05）. The incidence of middle cerebral artery stenosis in group WML （16. 5% vs 7. 0% ） was higher （χ^2 = 5. 568, P 〈 0. 05）. After adjustment of age, hypertension, diabetes, coronary heart disease, previous stroke history of these risk factors, logistic regression analysis showed that cerebral artery stenosis with WML risk related in patients with lacunar infarcts（OR = 2. 13, 95% CI 1. 18 - 3. 25, P 〈 0. 05 ）. Conclusions The middle cer

关 键 词：腔隙性脑梗死 脑白质病变 大脑中动脉 动脉狭窄 

分 类 号：R743.33[医药卫生—神经病学与精神病学]