缺血性脑血管病微出血与白质病变的相关性研究’  

Correlation study between cerebral microbleeds and white matter lesions in patients with ischemic ce- rebrovascular disease

作　　者：吕晓培[1] 滕振杰[2] 袁帅[3] 王聪杰[1] 李虹[1] 陈娜[1] 卢海丽[1] 史万英[1] 董艳红[2] 李婧[1] 张斌[1] 

机构地区：[1]石家庄市第一医院中心院区,石家庄050011 [2]河北省人民医院,石家庄050051 [3]河北省胸科医院,石家庄050048

出　　处：《中华行为医学与脑科学杂志》2017年第11期999-1002,共4页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：河北省科技支撑计划项目（14277787D）;河北省科学技术厅项目（16397795D）

摘　　要：目的探讨缺血性脑血管病（isehemia cerebrovascular disease，ICVD）微出血（cerebral microbleeds，CMBs）分布特点与危险因素，及其与白质病变（white matter lesions，WML）的相关性。方法收集2015年2月至2017年1月在河北省人民医院神经内科就诊的180例ICVD患者，进行头颅核磁共振成像（magneticresonanceimaging，MRI）、磁敏感加权成像（susceptibility weightedimaging，SWI）序列检查。记录患者基线资料及高血压、糖尿病、高脂血症、高同型半胱氨酸血症等危险因素，并对CMBs进行计数、分级，了解CMBs分布特点。应用Logisitic回归分析进行影响因素分析。将ICVD患者分为CMBs组与无CMBs组。CMBs组进一步按严重程度分为0～3级共4组，进一步研究CMBs影响因素与分级的相关性。再将ICVD患者分为WML组与无WML组，WML组采用年龄相关白质改变评分量表进行各个区域评分，进一步探讨WML与CMBs分级的相关性。结果（1）180例ICVD患者中，有CMBs者111例（61．7％），表现皮质及皮质下CMBs者80例（72．1％），其中颞叶皮质CMBs（49例，占61．3％）最常见，基底节及丘脑有CMBs者6l例（55．0％），幕下区域有CMBs者38例（34．2％），三者差异有统计学意义（X2=32．061，P〈0．01）。（2）年龄（B=0．046，OR=1．047，95％CI=1．017～1．077，P=0．002）与高同型半胱氨酸血症（B=1．458，OR=4．299，95％C／=2．114～8．744，P〈0．01）为影响CMBs的危险因素；（3）CMBs分级与WML总分存在正相关（r=0．393，P〈0．01）。结论ICVD患者CMBs最常见于颞叶；年龄和高同型半胱氨酸血症为CMBs的危险因素；随着WML总分增加，CMBs严重程度也增加。Objective To explore distribution characteristics and risk factors of cerebral microb- leeds （CMBs） ,and the correlation between CMBs and white matter lesions （WML） in patients with ische- mic cerebrovascular disease（ ICVD ）.Methods 180 patients with ICVD in neurology department of Hebei General Hospital from February 2015 to January 2017 were recruited. Those patients were underwent brain magnetic resonance imaging （ MRI）, and magnetic susceptibility weighted imaging （SW[）. Recorded the baseline data and risk factors of high blood pressure, diabetes, hyperlipidemia, and high homocysteine were recorded.Patients with CMBs were counted and graded to understand the characteristics of CMBs distribution. Logisitic regression analysis was used to analyze the influencing factors. ICVD patients were divided into CMBs group and non CMBs group. CMBs group was further divided into 4 groups according to the severity, which was divided into level 1-3. The correlation between CMBs influencing factors and classification was fur- ther studied.Then patients with ICVD were divided into WML group and non WML group. WML group scoredeach region with age-related white matter changes rating scale （ARWMCrs）. The correlation between WML and CMBs classification was further studied. Results （ 1 ） The overall prevalence of CMBs in patients with ICVD was 61.7% （111/180） .Tile most common location of CMBs in patients with ICVD was the cortical and subcortical regions （80/111,72. 1%）, followed by the basal ganglia and thalamus regions （61/111, 55.0% ） , and the infratentorial regions（ 38/111,34.2% ） .The difference between them were significant （ X2 = 32.061,P= 0.000）. In cortical and subcortical regions of CMBs, temporal lobe was the most common （ 61.3% ）. （2） Age（ B = 0.046, Or= 1.047,95% CI = 1.017 - 1.077, P= 0.002） and the high homocysteine （ B = 1.458, Or= 4.299,95%CI -- 2.114- 8.744 ,P〈0.001 ） were the risk factors for CMBs. （ 3 ） Four classifica- tion of CMBs was pos

关 键 词：缺血性脑血管病 脑微出血 危险因素 脑白质病变 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]