踝肱指数和急性脑梗死患者脑微出血的相关性研究  

Low ankle-brachial index predicts cerebral microbleeds in patients with ischemic stroke

作　　者：李传游[1] 肖婧[1] 丁彩霞[1] 汤银燕[1] 江雪梅[1] 朱羽佳[1] 胡丹[1] 张兰坤[1] 姜寒[1] 盛蕾[1] 

机构地区：[1]南京中医药大学第二附属医院江苏省第二中医院神经内科,南京医学硕士研究生210017

出　　处：《医学研究生学报》2017年第1期57-60,共4页Journal of Medical Postgraduates

基　　金：江苏省中医药局科技项目(LZ13092);江苏省中医药局(YB2015052)

摘　　要：目的踝肱指数(ABI)异常和心脑血管病事件的发生显著相关,但关于ABI水平与脑微出血(CMB)的相关性研究较少。文中旨在探讨异常ABI(≤0.9)和CMB发生及分布模式的相关性。方法连续纳入2015年1月至2015年12月入住于江苏省第二中医院神经内科诊断为脑梗死的患者187例。根据磁共振检查结果分为CMB阴性组115例和CMB阳性组72例(CMBs阳性)。根据CMB部位,又分为单纯脑叶组20例,深部CMB组24例,混合CMB组28例。单因素分析组间差异,同时多因素logistic回归分析ABI≤0.9与CMB的发生及分布的相关性。结果患者中ABI≤0.9者57例(30.5%)。与CMB阴性组ABI≤0.9发生率比较,CMB阳性组显著升高(22.6%vs 43.1%,P=0.003)。ABI水平和CMB数量存在显著负相关(r=-0.211,P=0.006)。多元logistic回归分析校正混杂因素后示:ABI≤0.9是缺血性脑血管病患者发生CMB(OR=2.363;95%CI:1.181~4.729)、深部CMB(OR=3.434;95%CI:1.283~9.187)及混合CMB(OR=2.837;95%CI:1.098~7.333)的危险因素。结论 ABI下降的急性脑梗死患者较易发生CMB,尤其是深部CMB。Objective The abnormal ankle-brachial index（ ABI） is associated with the incidence of cardiocerebral vascular diseases,but little is known about its relationship with cerebral microbleeds（ CMB）. This study aimed to investigate the correlation between ABI≤0.9 and different distribution patterns of CMB. Methods We enrolled 187 patients with acute lacunar infarction,including 115 non-CMB cases and 72 CMB cases（ 20 strictly lobar,24 strictly deep,and 28 lobar and deep）. We analyzed the differences between the two groups and the association of abnormal ABI with the occurrence and distribution of CMB by logistic regression analysis.Results ABI≤0.9 was found in 57（ 30.5%） of the patients,with a significantly higher incidence rate in the CMB group than in the non-CMB group（ 43.1% vs 22.6%,P = 0.003）. The level of ABI was negatively correlated with the number of CMBs（ r =-0.211,P =0. 006）. Multivariate logistic regression analysis after adjusted for confounders indicated that ABI ≤0.9 was significantly associated with the presence of CMB（ OR = 2.363; 95% CI： 1.181-4.729）,deep CMB（ OR = 3.434; 95% CI： 1.283-9.187）,and lobar and deep CMB（ OR = 2.837; 95% CI： 1.098-7.333） in patients with ischemic cerebrovascular disease. Conclusion Decreased ABI is a risk factor of CMB,particularly deep CMB,in patients with ischemic stroke.

关 键 词：踝肱指数 脑梗死 脑微出血 

分 类 号：R743.33[医药卫生—神经病学与精神病学]