MRI脑小血管病总体负担与中老年人远期首次症状性缺血性脑卒中的关系  被引量:3

Relationship between the overall burden of MRI cerebral small vessel disease and long-term first symptomatic ischemic stroke in middle-aged and elderly people

在线阅读下载全文

作  者:吴祖伟 周岚[1] WU Zuwei;ZHOU Lan(Taihe Hospital of Shiyan,Shiyan 442000,China)

机构地区:[1]十堰市太和医院,湖北十堰442000

出  处:《中国实用神经疾病杂志》2021年第22期1976-1987,共12页Chinese Journal of Practical Nervous Diseases

摘  要:目的探讨MRI脑小血管病(CSVD)总体负担与中老年人远期首次症状性缺血性脑卒中的关系。方法选择2015-06—2019-05在十堰市太和医院神经内科住院治疗的138例首次腔隙性梗死的患者为病例组,另选择同期在神经内科住院治疗的非腔隙性梗死的脑小血管病患者138例为对照组,对比2组患者的一般资料、影像学标志物及小血管病评分(SVD)。通过Logistic回归分析腔隙性梗死的独立危险因素,并建立预测模型。采用Spearman等级相关分析CSVD总体负担的相关因素。结果病例组与对照组在男性、BMI、吸烟史、饮酒史、收缩压和舒张压、缺血性心脏病、动脉粥样硬化、空腹血糖(FBG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)等方面差异均有统计学意义(P<0.05)。病例组87例患者有1个以上的腔隙,66例患者表现为重度白质病变(室周WML Fazekas评分3分)和深部WMLs评分2分或3分,52例患者至少有1个脑微出血(CMBs),76例患者有中到重度血管周围间隙扩大(EPVSs),各项相对于对照组比例更高(P<0.05)。二元Logistic回归分析病例组相对于对照组的独立危险因素,结果表明吸烟史、高血压、缺血性心脏病、动脉粥样硬化以及SVD评分是腔隙性梗死发生的独立危险因素。基于腔隙性梗死的影响因素构建预测模型:预测值=EXP[1.557—0.941(SVD评分)—1.700(吸烟史)—1.546(高血压)—1.361(缺血性心脏病)—1.588(动脉粥样硬化)],该模型AUC为0.895。Spearman等级相关分析表明年龄、高血压、入院时NIHSS评分与SVD评分均呈正向等级相关(r=1.367、2.359、1.639,P<0.001)。结论 CSVD总体负担是中老年人远期首次腔隙性梗死的独立危险因素,SVD评分对于腔隙性梗死具有重要预测价值。此外,SVD评分与年龄、高血压、入院时NIHSS评分密切相关,对首次腔隙性梗死患者的预防及治疗具有一定的参考价值。Objective Objective To explore the relationship between the overall burden of MRI cerebral small vessel disease and the first long-term symptomatic ischemic stroke in middle-aged and elderly people.Methods Totally 138 patients with first lacunar infarction who were hospitalized in the Department of Neurology of our hospital from June 2015 to May 2019 were as selected as case group,and 138 patients with small vessel disease for non-lacunar infarction who were hospitalized in the Department of Neurology of our hospital during the same period were selected as control group,and the general information,imaging markers and SVD scores of the two groups were compared. Logistic regression was used to analyze the independent risk factors of lacunar infarction and establish a predictive model. In addition,Spearman rank correlation was used to analyze the factors related to the overall burden of CSVD.Results The differences between the case group and the control group in male,BMI,smoking history,drinking history,systolic and diastolic blood pressure,ischemic heart disease,atherosclerosis,FBG,TC,HDL were statistically significant(P<0.05). In the case group,87 patients had more than one cavity,66 patients showed severe white matter lesions(periventricular WML Fazekas score 3 points)and deep WMLs score 2 or 3 points,52 patients had at least one CMBs,and 76 patients There are moderate to severe EPVSs,and the proportion of each item is higher than that of the control group(P<0.05). Binary Logistic regression analysis of the independent risk factors of the case group relative to the control group showed that smoking history,hypertension,ischemic heart disease,atherosclerosis and SVD score are independent risk factors for lacunar infarction. Construct a predictive model based on the influencing factors of lacunar infarction:predictive value=EXP(1.557 — 0.941(SVD score)— 1.700(smoking history)— 1.546(hypertension)— 1.361(ischemic heart disease)— 1.588(artery))Atherosclerosis,the AUC of this model is 0.895. Spearman rank co

关 键 词:脑小血管病 总体负担 腔隙性梗死 缺血性脑卒中 影响因素 

分 类 号:R743.3[医药卫生—神经病学与精神病学]

 

参考文献:

正在载入数据...

 

二级参考文献:

正在载入数据...

 

耦合文献:

正在载入数据...

 

引证文献:

正在载入数据...

 

二级引证文献:

正在载入数据...

 

同被引文献:

正在载入数据...

 

相关期刊文献:

正在载入数据...

相关的主题
相关的作者对象
相关的机构对象