血管周围间隙进展与腔隙性脑梗死发生的相关研究  

Correlational research between progression of Virchow-Robin spaces and occurrence of lacunar infarction

作　　者：朱圆圆 蒋文昊 龚宇 朱颖[1] 于明[1] ZHU Yuan-yuan;JIANG Wen-hao;GONG Yu(Department of Neurology,Affiliated Hospital of Jiangsu University,212001 Zhenjiang,China)

机构地区：[1]江苏大学附属医院神经内科,镇江212001 [2]江苏大学医学院

出　　处：《临床神经病学杂志》2020年第1期23-26,共4页Journal of Clinical Neurology

摘　　要：目的探讨血管周围间隙(VRS)进展和腔隙性脑梗死(LI)发生的相关性。方法在基线期和2年后对295例VRS患者进行头颅MRI检查,分析VRS合并LI患者(VL组)和VRS不伴LI患者(VOL组)的VRS评分及体积。根据VRS进展情况将患者分为无进展组、轻中度进展组和重度进展组,比较LI发生率和进展率,并采用Logistic单因素和多因素分析评估VRS进展与LI发生的相关性。结果共纳入223例VRS患者,其中VL组126例,VOL组97例。与VOL组比较,VL组第1次和第2次扫描的VRS评分差异无统计学意义(均P>0.05)。VL组和VOL组两次扫描的VRS评分及VRS评分变化差值无统计学意义(均P>0.05)。与VOL组比较,VL组第1次扫描和第2次扫描的VRS体积及△VRS体积均显著升高(均P<0.05)。VL组和VOL组第2次扫描的VRS体积均显著高于第1次扫描(均P<0.05)。VRS无进展组LI发生率为51.27%,VRS轻中度进展组为63.51%,VRS重度进展组为72.85%,趋势检验具有统计学差异(P=0.027)。两次扫描结果显示,VRS无进展组LI进展率为16.53%,VRS轻中度进展组LI进展率为23.89%,VRS重度进展组LI进展率为31.67%,趋势检验亦具有统计学意义(P=0.013)。Logistic单因素分析显示,与VRS无进展组相比,VRS轻中度进展组和重度进展组发生LI的风险显著增加(OR=3.61,OR=4.98;均P<0.05)。多因素分析显示,与无进展组比较,VRS轻中度进展组和重度进展组LI发病风险显著升高(OR=2.54,OR=3.86;均P<0.05)。结论VRS的进展可促进LI的发生,是LI发生发展的重要危险因素。Objective To explore the correlation between progression of Virchow-Robin spaces(VRS)and the occurrence of lacunar infarcts(LI).Methods A total of 295 patients with VRS were examined by brain MRI at baseline and two years later.Both scoring and volume quantitative methods of VRS were analyzed in VRS with LI patients(VL group)and VRS without LI patients(VOL group).Meanwhile,the patients were divided into nonprogression group,mild-to-moderate progression group and severe progression group according to the degree of VRS progression.The incidence and progress rate of LI were compared in the three groups.Afterwards,univariate and multivariate Logistic analysis were used to evaluate the correlation between the progress of VRS and the occurrence of LI.Results A total of 223 VRS patients were included,including VL group(n=126)and VOL group(n=97).Compared with those in VOL group,there was no significant difference in the VRS scores of 1 st and 2 nd scans in the VL group(all P>0.05).There was also no significant difference in VRS score and△VRS score between VL and VOL groups(all P>0.05).Compared with those in VOL group,VRS volumes in 1 st scans and 2 nd scans andΔVRS volumes were significantly higher in VL group(all P<0.05).The VRS volume of VL group and VOL group in the 2 nd scans was significantly higher than that in the 1 st scans(all P<0.05).The incidence of LI in VRS nonprogression group was 51.27%,that in VRS mild-to-moderate progression group was 63.51%,and that in VRS severe progression group was 72.85%.There was significant difference in trend test(P=0.027).The results of the two scans showed that the progress rate of LI was 16.53%in the VRS non-progression group,23.89%in the VRS mild-to-moderate progression group,and 31.67%in the VRS severe progression group.The trend test was statistically significant(P=0.013).Logistic univariate analysis showed that the risk of LI occurrence was significantly increased in VRS mild-to-moderate progression group and VRS severe progression group versus that in VRS non-progressi

关 键 词：血管周围间隙 进展 腔隙性脑梗死 体积 

分 类 号：R743[医药卫生—神经病学与精神病学]