脑微出血和无症状腔隙性脑梗死引起再发卒中的比较研究  

A comparative study on recurrent stroke caused by cerebral microbleed or asymptomatic lacunar infarction

作　　者：张艳洁 刘晓盼 耿德勤 张传会 王炎强 Zhang Yanjie;Liu Xiaopan;Geng Deqin;Zhang Chuanhui;Wang Yanqiang(Graduate School,Xuzhou Medical University,Xuzhou 221004,China;the Department of Neurology II,Shandong Rehabilitation Hospital,Jinan 250000,China;Department of Neurology II,the Affiliated Hospital of Weifang Medical University,Weifang 261031,China;Department of Neurology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China;Department of Neurology II,Shandong Rehabilitation Hospital,Jinan 250000,China;the Department of Neurology II,the Affiliated Hospital of Weifang Medical University,Weifang 261031,China)

机构地区：[1]徐州医科大学研究生院,徐州221004 [2]山东省康复医院神经内二科工作,济南250000 [3]潍坊医学院附属医院神经内二科,潍坊261031 [4]徐州医科大学附属医院神经内科,徐州221006 [5]山东省康复医院神经内二科,济南250000 [6]潍坊医学院附属医院神经内二科工作,潍坊261031

出　　处：《中国医师进修杂志》2024年第12期1064-1067,共4页Chinese Journal of Postgraduates of Medicine

基　　金：潍坊市科技发展计划项目(2022YX093);潍坊医学院附属医院临床医学研究中心项目(2022WYFYLCYJ02);国家卫生健康委员会脑卒中防治工程委员会中国脑卒中高危人群干预适宜技术研究及推广项目(GN20180009)。

摘　　要：目的探讨脑微出血(CMB)和无症状腔隙性脑梗死(ALI)引起再发卒中风险及其危险因素。方法前瞻性选择2020年3月至2022年6月在徐州医科大学附属医院就诊的非脑卒中患者397例,依据磁共振检查有无CMB和ALI,分为对照组(CMB和ALI均无,117例,占29.5%)、ALI组(101例,占25.4%)、CMB组(89例,占22.4%)及CMB-ALI组(90例,占22.7%)。随访18个月,分析引发CMB、ALI的危险因素及新发卒中的风险。结果CMB组收缩压及尿酸水平高于对照组[(155.2±24.2)mmHg(1 mmHg=0.133 kPa)比(138.2±19.0)mmHg、(387.0±28.3)μmol/L比(354.0±21.5)μmol/L],差异有统计学意义(P<0.05)。随访18个月,CMB组和CMB-ALI组急性缺血性脑卒中、脑出血、短暂性脑缺血发作发病率均高于对照组[13.5%(12/89)、13.3%(12/90)比5.1%(6/117),9.0%(8/89)、10.0%(9/90)比2.6%(3/117),5.6%(5/89)、6.7%(6/90)比0.8%(1/117)],差异有统计学意义(P<0.05)。结论CMB患者的收缩压和尿酸异常升高;CMB和CMB合并ALI患者易出现再发缺血性脑卒中、脑出血和短暂性脑缺血发作。ObjectiveTo investigate the risk of new-onset stroke caused by cerebral microbleed(CMB)and asymptomatic lacunar infarction(ALI)and their risk factors.MethodsA prospective observational study over a 18 month period was conducted on 397 non stroke patients who visited the Affiliated Hospital of Xuzhou Medical University from March 2020 to June 2022.By the presence of CMB and ALI about magnetic resonance imaging,they were divided into th control group(without CMB and ALI,117 cases,29.5%),ALI group(101 cases,25.4%),CMB group(89 cases,22.4%)and CMB-ALI group(90 cases,22.7%).They were followed up for 18 months,the risk factors for CMB,ALI,and the risk of new stroke were analyzed.ResultsThe systolic blood pressure and uric acid in the CMB group were higher than those in the control group:(155.2±24.2)mmHg(1 mmHg=0.133 kPa)vs.(138.2±19.0)mmHg,(387.0±28.3)μmol/L vs.(354.0±21.5)μmol/L,there were statistical differences(P<0.05).After followed up for 18 months,the incidence rate of cerebral infarction,cerebral hemorrhage and TIA in the CMB group and CMB-ALI group were higher than those in the control group:13.5%(12/89),13.3%(12/90)vs.5.1%(6/117);9.0%(8/89),10.0%(9/90)vs.2.6%(3/117);5.6%(5/89),6.7%(6/90)vs.0.8%(1/117),there were statistical differences(P<0.05).ConclusionsCMB is prone to abnormal systolic blood pressure and uric acid.CMB,CMB-ALI are prone to new onset ischemic stroke,cerebral hemorrhage and TIA.

关 键 词：脑微出血 无症状腔隙性脑梗死 再发卒中 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]