脑微出血在急性脑血管病患者中的发生率及危险因素调查研究  

The prevalence of cerebral microbleeds among acute cerebral vascular diseases and associated risk factors analysis

作　　者：高忠明[1] 何吉庆[1] 姜海波[1] 卢晓东[1] 王小川[1] 

机构地区：[1]杭州师范大学附属医院,浙江杭州310015

出　　处：《中国预防医学杂志》2017年第1期44-48,共5页Chinese Preventive Medicine

摘　　要：目的观察不同急性脑血管病患者脑微出血(CMBs)的患病率,并分析其危险因素。方法选取2013年10月~2015年10月,杭州师范大学附属医院急性脑血管疾病患者158例纳入研究,将同期住院治疗的非脑血管病患者68例纳入对照组。记录不同类型脑血管病患者CMBs的患病率,并对其临床资料、生化指标及影像学检查进行分析,探求CMBs的危险因素。采用SPSS 17.0软件,计量资料采用随机样本t检验,计数资料比较采用χ2检验或Fisher确切概率法,P<0.05为差异有统计学意义。结果急性脑出血及脑梗死CMBs检出率(73.68%、46.15%)均高于对照组(11.76%),差异均有统计学意义(χ2=49.536、20.405,P<0.01),但短暂性脑缺血发作(21.74%)与对照组CMBs检出率(11.76%)差异无统计学意义(P>0.05)。Logistic回归分析显示,入院时收缩压(OR=4.469)、高血压病史(OR=8.921)、同型半胱氨酸(OR=3.067)、糖化血红蛋白(OR=2.530)、脑出血(OR=5.212)、脑白质疏松(OR=12.253)是发生CMBs的危险因素。结论急性脑出血及脑梗死患者脑微出血的患病率较高,入院时高收缩压、高血压病史、高同型半胱氨酸、高糖化血红蛋白、脑出血、合并脑白质疏松是脑微出血的危险因素。Objective To observe the prevalence of cerebral microbleeds （CMBs） among different acute cerebral vascular diseases and to investigate the associated risk factors. Methods 158 cases with acute cerebral vascu- lar diseases and 68 controls were enrolled. The clinical characteristics, biochemical and imaging indexes were collected. The prevalence of microbleeds and associated risk factors were analyzed. Results The prevalence of CMBs in cerebral hemorrhage, cerebral infarction, transient ischemic attack （TIA） and the controls were 73.68%, 46. 15%, 21.74%, 11.76%, respectively. The ratios of CRBs in hemorrhage and cerebral infarction were significantly higher than those in the controls （χ2 = 49. 536, 20. 405, all P〈0.05）, but there was no difference between TIA and the controls （P〉0.05） . The logistic regression analysis showed that, the risk factors of CMBs were higher systolic pressure （OR=4. 469）, history of hypertension （OR= 8.921 ）, hyperho mocysteine （OR =3.067）, glycosylated hemoglobin （0R=2.530）, cerebral hemorrhage （OR=5.212,） and leukoencephalopathy （OR=12. 253） . Conclusions The prevalence of CMBs is high in acute cerebral hem orrhage and infarction. The risk factors of CMBs are higher systolic pressure, history of hypertension, hyper- homocysteine, higher glycosylated hemoglobin, cerebral hemorrhage and leukoencephalopathy.

关 键 词：脑微出血 急性脑血管病 危险因素 磁敏感加权成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]