脑梗死对影像学脑小血管病患者表现的影响及相关因素分析  

Analysis related risk factors in patients of cerebral infarction with imaging of cerebral small vessel disease

作　　者：范昊龙 唐丽梅[1] 乔会敏[1] 杜媛媛[1] 赵田祎 王素欢 李震中[1] 董梅[1] Fan Haolong;Tang Limei;Qiao Huimin;Du Yuanyuan;Zhao Tianyi;Wang Suhuan;Li Zhenzhong;Dong Mei(Department of Neurology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院神经内科,神经病学河北省重点实验室,石家庄050000

出　　处：《脑与神经疾病杂志》2022年第10期630-634,共5页Journal of Brain and Nervous Diseases

基　　金：河北省卫生健康委重点科技研究项目(20220996)。

摘　　要：目的 许多老年患者有脑小血管病(CSVD)影像学表现,但无特征性临床症状,本研究探讨脑梗死(CI)的发生对有CSVD影像学表现患者的影响及相关因素分析。方法 收集老年患者,MRI检查为多发性腔隙性脑梗死(LI),脑白质病变(WMH)或脑萎缩等一种或多种表现,按照是否有CI临床症状分为CI组和非CI组,CI组包括既往有CI史和新发CI患者,所有患者于入院7d内行MMSE认知测评、ADL评分,对比两组患者一般资料、影像学类型、既往病史、生活方式等,并对相关因素分析。结果 共入组460例患者,CI组307例,占66.74%,与非CI组相比,患者在性别、高血压、吸烟、饮酒、NIHSS评分、跌倒评分、ADL评分、影像学类型等方面存在明显差异;两组在年龄、婚姻、糖尿病、冠心病等方面无差异;Logistic多因素回归分析,男性、高血压、ADL评分及影像学类型与CI发生密切相关。随CI发生次数增多,血管性痴呆(VaD)病例增多,差异有统计学意义。结论 影像学cSVD表现的CI组,男性、高血压是其独立危险因素,与跌倒评分、ADL评分、影像学受累程度呈正相关,CI组VaD发病数量增多,应引起临床医生关注。Objective Many elderly patients have imaging findings of cerebral small vessel disease(CSVD)without obvious clinical manifestation.The purpose of this study was to explore the incidence of cerebral infarction(CI)and related factors with imaging of CSVD.Method Patients were selected with multiple lacunar infarction(LI),with white matter hyperintensities(WMH)or brain atrophy in MRI,some of which had new cerebral infarction and/or old CI,and divided into CI group and non-CI group.MMSE cognitive test and ADL score were performed within 7 days after onset.The imaging results,past history,lifestyle,ADL score,MMSE and MRI of the two groups were compared.Result 460 patients were selected in accordance with the imaging findings.307 were in CI group(66.74%).There were significant differences in gender,hypertension,smoking,drinking,NIHSS score,fall score,ADL score and imaging findings.There was no difference in age,marriage,diabetes,coronary heart disease between two groups.Logistic multivariate regression analysis showed that male,hypertension,ADL score and imaging findings were closely related to the occurrence of cerebral infarction.With the occurrence of CI,vascular dementia(VaD) increased.Conclusion CI occurs in patients with imaging of CSVD,Male and hypertension are independent risk factors,which are positively correlated with fall score,ADL score and imaging involvement.After CI,the number of VaD increases.

关 键 词：脑小血管病 脑梗死 血管性痴呆 影像学 

分 类 号：R743.34[医药卫生—神经病学与精神病学]