中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2015年
1期
31-34
,共4页
刘寒%王龙%周霞%江婵娟%孙中武
劉寒%王龍%週霞%江嬋娟%孫中武
류한%왕룡%주하%강선연%손중무
代谢综合征X%缺氧缺血,脑%磁共振成像
代謝綜閤徵X%缺氧缺血,腦%磁共振成像
대사종합정X%결양결혈,뇌%자공진성상
Metabolic syndrome X%Hypoxia-ischemia,brain%Magnetic resonance
目的 探讨代谢综合征及其各因子对皮质下缺血性脑血管病(SIVD)影像学损害的影响. 方法 选取120例SIVD患者(SIVD组),年龄其中包括非代谢综合征患者25例,代谢综合征倾向患者25例,代谢综合征患者70例.代谢综合征的诊断标准采用美国国家胆固醇教育计划成人治疗专家组Ⅲ(NCEP-ATPⅢ)标准.SIVD影像学损害采用改良Scheltens量表对头颅MRI进行评价,分为脑室旁、脑白质、基底节三个脑区评定并计算总分. 结果 代谢综合征倾向组脑室旁、脑白质、基底节评分、Scheltens总分[(3.75±1.60)分、(10.67±5.26)分、(3.21±2.62)分、(17.62±8.32)分]和代谢综合征组[(4.21±1.09)分、(13.79±5.25)分、(6.90±4.25)分、(24.90±9.25)分]均显著高于非代谢综合征组[(2.76±1.62)分、(6.36±3.93)分、(1.52±1.50)分、(10.58±5.89)分,均P＜0.05].腰围与脑白质得分及Scheltens总分呈显著正相关(r=0.185,P=0.046; r=0.488,P＜0.001);三酰甘油(TG)与脑白质、基底节得分有显著正相关(r=0.188,P=0.042; r=0.311,P=0.001);空腹血糖与脑白质、基底节得分以及Scheltens总分呈显著正相关(r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027);高密度脂蛋白胆同醇(HDL C)与脑白质、基底节以及Schehens总分呈显著负相关(r=-0.238,P=0.010; r=-0.189,P=0.042;r=-0.335,P＜0.001).进一步多元线性逐步回归分析结果发现空腹血糖、HDL C与脑白质评分显著相关(P均＜0.05);TG与基底节评分显著相关(P＜0.05);腰围、空腹血糖、HDL-C与Scheltens总分显著相关(P均＜0.05). 结论 代谢综合征及其各因子与SIVD影像学损害相关,其中腹型肥胖、TG、空腹血糖、HDL-C是SIVD的重要危险因素.
目的 探討代謝綜閤徵及其各因子對皮質下缺血性腦血管病(SIVD)影像學損害的影響. 方法 選取120例SIVD患者(SIVD組),年齡其中包括非代謝綜閤徵患者25例,代謝綜閤徵傾嚮患者25例,代謝綜閤徵患者70例.代謝綜閤徵的診斷標準採用美國國傢膽固醇教育計劃成人治療專傢組Ⅲ(NCEP-ATPⅢ)標準.SIVD影像學損害採用改良Scheltens量錶對頭顱MRI進行評價,分為腦室徬、腦白質、基底節三箇腦區評定併計算總分. 結果 代謝綜閤徵傾嚮組腦室徬、腦白質、基底節評分、Scheltens總分[(3.75±1.60)分、(10.67±5.26)分、(3.21±2.62)分、(17.62±8.32)分]和代謝綜閤徵組[(4.21±1.09)分、(13.79±5.25)分、(6.90±4.25)分、(24.90±9.25)分]均顯著高于非代謝綜閤徵組[(2.76±1.62)分、(6.36±3.93)分、(1.52±1.50)分、(10.58±5.89)分,均P＜0.05].腰圍與腦白質得分及Scheltens總分呈顯著正相關(r=0.185,P=0.046; r=0.488,P＜0.001);三酰甘油(TG)與腦白質、基底節得分有顯著正相關(r=0.188,P=0.042; r=0.311,P=0.001);空腹血糖與腦白質、基底節得分以及Scheltens總分呈顯著正相關(r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027);高密度脂蛋白膽同醇(HDL C)與腦白質、基底節以及Schehens總分呈顯著負相關(r=-0.238,P=0.010; r=-0.189,P=0.042;r=-0.335,P＜0.001).進一步多元線性逐步迴歸分析結果髮現空腹血糖、HDL C與腦白質評分顯著相關(P均＜0.05);TG與基底節評分顯著相關(P＜0.05);腰圍、空腹血糖、HDL-C與Scheltens總分顯著相關(P均＜0.05). 結論 代謝綜閤徵及其各因子與SIVD影像學損害相關,其中腹型肥胖、TG、空腹血糖、HDL-C是SIVD的重要危險因素.
목적 탐토대사종합정급기각인자대피질하결혈성뇌혈관병(SIVD)영상학손해적영향. 방법 선취120례SIVD환자(SIVD조),년령기중포괄비대사종합정환자25례,대사종합정경향환자25례,대사종합정환자70례.대사종합정적진단표준채용미국국가담고순교육계화성인치료전가조Ⅲ(NCEP-ATPⅢ)표준.SIVD영상학손해채용개량Scheltens량표대두로MRI진행평개,분위뇌실방、뇌백질、기저절삼개뇌구평정병계산총분. 결과 대사종합정경향조뇌실방、뇌백질、기저절평분、Scheltens총분[(3.75±1.60)분、(10.67±5.26)분、(3.21±2.62)분、(17.62±8.32)분]화대사종합정조[(4.21±1.09)분、(13.79±5.25)분、(6.90±4.25)분、(24.90±9.25)분]균현저고우비대사종합정조[(2.76±1.62)분、(6.36±3.93)분、(1.52±1.50)분、(10.58±5.89)분,균P＜0.05].요위여뇌백질득분급Scheltens총분정현저정상관(r=0.185,P=0.046; r=0.488,P＜0.001);삼선감유(TG)여뇌백질、기저절득분유현저정상관(r=0.188,P=0.042; r=0.311,P=0.001);공복혈당여뇌백질、기저절득분이급Scheltens총분정현저정상관(r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027);고밀도지단백담동순(HDL C)여뇌백질、기저절이급Schehens총분정현저부상관(r=-0.238,P=0.010; r=-0.189,P=0.042;r=-0.335,P＜0.001).진일보다원선성축보회귀분석결과발현공복혈당、HDL C여뇌백질평분현저상관(P균＜0.05);TG여기저절평분현저상관(P＜0.05);요위、공복혈당、HDL-C여Scheltens총분현저상관(P균＜0.05). 결론 대사종합정급기각인자여SIVD영상학손해상관,기중복형비반、TG、공복혈당、HDL-C시SIVD적중요위험인소.
Objective To investigate the effect of metabolic syndrome and its components on imaging of brain impairment in subcortical ischemic vascular disease.Methods 120 patients with subcortical ischemic vascular disease (SIVD) including 25 cases without metabolic syndrome,25 cases with the risk of metabolic syndrome,70 cases with metabolic syndrome.The diagnostic criteria of metabolic syndrome was the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ).Brain MRI was assessed by the Scheltens scale,and divided into 3 regions:periventricular hyper intensities (PVH),leukoaraiosis (LA),basal ganglia hyper-intensities (BG).Results The assessment scores of PVH,LA,BG and Scheltens scores were higher in patients with the risk of metabolic syndrome and patient with metabolic syndrome than in patient without metabolic syndrome [(3.75±1.60),(4.21±1.09) us.(2.76±1.62),(10.67±5.26),(13.79±5.25) us.(6.36±3.93),(3.21±2.62),(6.90±4.25) us.(1.52±1.50),(17.62±8.32),(24.90±9.25)vs.(10.58± 5.89),respectively,all P＜0.05].Waist circumference had positive correlations with LA and Scheltens scores (r=0.185,P=0.046; r=0.488,P＜0.001).Positive correlation was found between triglyceride (TG) and LA,BG scores (r=0.188,P=0.042; r=0.311,P =0.001).The positive correlations of impaired glucose tolerance (IGT) with LA,BG and Scheltens scores were found (r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027).High density lipoproteincholesterol (HDL-C) was correlated negatively with LA,BG and Scheltens scores (r=-0.238,P=0.010;r=-0.189,P=0.042; r=-0.335,P＜0.001).The further multivariate linear regression analysis showed that IGT,HDL-C had significant correlations with LA assessment score (both P＜0.05),TG had significant correlation with BG assessment score (P＜0.05),and waist circumfernce,IGT,HDL-C had significant correlations with Scheltens scores (all P＜ 0.05).Conclusions Metabolic syndrome and its components correlate with the imagings of cerebral damage in SIVD.Abdominal obesity,TG,IGT,HDL-C are the important risk factors for SIVD.
