急性脑梗死患者脑微出血的危险因素及其对心脑血管事件发生率影响的研究  

Study on risk factors of cerebral microbleeds and its effect on incidence of cardiovascular and cerebrovascular events in patients with acute cerebral infarction

作　　者：朱慧颖[1] 余萍[1] 梅俊华[1] 刘文华 陈玲[1] 彭红芬[1] Hui-ying Zhu;Ping Yu;Jun-hua Mei;Wen-hua Liu;Ling Chen;Hong-fen Peng(Department of Neurology,Wuhan No. 1 Hospital,Wuhan,Hubei 430022,China)

机构地区：[1]武汉市第一医院神经内科,湖北武汉430022

出　　处：《中国现代医学杂志》2019年第3期88-92,共5页China Journal of Modern Medicine

基　　金：湖北省武汉市卫生局项目(No:WX14CO2)

摘　　要：目的研究急性脑梗死(ACI)患者脑微出血(CMBs)的影响因素,以及CMBs对ACI患者再发心脑血管事件发生率的影响。方法选取2014年3月—2017年4月武汉市第一医院神经内科住院的ACI患者131例,分为无CMBs组(85例)和CMBs组(46例)。根据两组患者的吸烟、饮酒、糖尿病、高血压、脑出血等既往史,探讨引起ACI患者CMBs的危险因素,并分析CMBs对两组患者心脑血管事件发生情况的影响。结果脑梗死、脑出血既往史是引起CMBs的危险因素,年龄、性别、抽烟、高血压、冠状动脉粥样硬化性心脏病(以下简称冠心病)等一般资料不是CMBs的危险因素。131例患者中46例CMBs,共查出脑微出血183个;46例CMBs中,重度17例,中度13例,轻度16例。心脑血管事件主要为再发脑卒中、脑梗死、脑出血、缺血性心脏病以及死亡。CMBs组患者的再发脑卒中和脑出血发生率与无CMBs组比较,差异有统计学意义(P <0.05);CMBs组患者的脑梗死、缺血性心脏病及病死率与无CMBs组比较,差异无统计学意义(P>0.05);CMBs严重程度与再发脑卒中发生率差异有统计学意义(P<0.05),重度CMBs组的发生率最高;脑梗死、脑出血、缺血性心脏病及病死率与CMBs严重程度差异无统计学意义(P>0.05)。结论脑梗死、脑出血既往史是脑微出血的危险因素,而脑微出血也可一定程度增加ACI患者再发心脑血管事件发生率,脑微出血严重程度与脑出血发生率呈正相关。Objective To investigate the influencing factors of brain microbleeds(CMBs)in patients with acute cerebral infarction(ACI)and the effect of CMBs on the incidence of recurrent cardiovascular and cerebrovascular events in patients with ACI.Methods A total of 131 ACI patients admitted to the Department of Neurology,Wuhan NO.1 Hospital from March 2014 to April 2017 were enrolled.The patients were divided into non-CMBs group(85 cases)and CMBs group(46 cases).According to the previous history of smoking,drinking,diabetes,hypertension,cerebral hemorrhage,the risk factors of CMBs in patients with ACI were discussed,and the effect of CMBs on the occurrence of cardiovascular and cerebrovascular events were analyzed.Results The past history of cerebral infarction and cerebral hemorrhage was a risk factor for CMBs.The general data such as age,gender,smoking,hypertension,coronary atherosclerotic heart disease(hereinafter referred to as coronary heart disease)were not risk factors for CMBs.Of the 131 patients,46 were CMBs,and 183 brain microbleeds were detected.Of the 46 CMBs,17 were severe,13 were moderate,and 16 were mild.Cardiovascular and cerebrovascular events were mainly recurrent stroke,cerebral infarction,cerebral hemorrhage,ischemic heart disease and death.The incidence of recurrent stroke and cerebral hemorrhage in the CMBs group was significantly lower than that in the non-CMBs group(P<0.05).The cerebral infarction,ischemic heart disease and mortality in the CMBs group were compared with those without CMBs.The difference was not statistically significant(P >0.05);the difference between the severity of CMBs and the incidence of recurrent stroke was statistically significant(P<0.05),and the incidence of severe CMBs was the highest.There was no significant difference between the severity of CMBs and the incidence of cerebral infarction,cerebral hemorrhage,ischemic heart disease and death(P >0.05).Conclusions The past history of cerebral infarction and cerebral hemorrhage is a risk factor for CMBs,and CMBs can also incr

关 键 词：脑出血 脑梗死/脑梗塞 磁共振磁敏感加权成像/磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]