实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
PRACTICAL JOURNAL OF CARDIAC CEREBRAL PNEUMAL AND VASCULAR DISEASE
2015年
5期
17-21
,共5页
脑白质疏松症%危险因素%侧脑室%半卵圆中心%颅外血管狭窄
腦白質疏鬆癥%危險因素%側腦室%半卵圓中心%顱外血管狹窄
뇌백질소송증%위험인소%측뇌실%반란원중심%로외혈관협착
Leukoaraiosis%Risk factors%Lateral ventricles%Centrum semiovale%Extracranial vascular stenosis
目的：探讨不同位置中重度脑白质疏松（ LA）的危险因素，以提高对该病的认识。方法选择2012年4月—2014年3月在洪泽县人民医院神经内科诊断的短暂性脑缺血发作（ TIA）或脑梗死患者195例。回顾性性分析患者的临床资料、颅脑MRI检查结果，采用Fazekas评分法分别对侧脑室旁LA和半卵圆中心LA进行严重程度分级，采用多因素Logistic回归分析筛选不同部位中重度LA的危险因素。结果侧脑室旁无或轻度LA患者78例，侧脑室旁中重度LA患者117例，不同严重程度侧脑室旁LA患者年龄、高血压发生率、卒中史阳性率、颅外血管狭窄率及尿素、肌酐水平比较，差异有统计学意义（ P<0.05）；半卵圆中心无或轻度LA患者43例，半卵圆中心中重度LA患者152例，不同严重程度半卵圆中心LA患者年龄、高血压发生率、卒中史阳性率、颅外血管狭窄率及尿素水平比较，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，高龄、高血压、颅外血管狭窄是侧脑室旁中重度LA的危险因素（P<0.05）；而高龄、高血压、有卒中史是半卵圆中心中重度LA的危险因素（P<0.05）。结论中重度侧脑室旁LA和半卵圆中心LA具有不同的危险因素，高龄、高血压是LA最主要的危险因素，而颅外血管狭窄主要影响侧脑室旁LA。
目的：探討不同位置中重度腦白質疏鬆（ LA）的危險因素，以提高對該病的認識。方法選擇2012年4月—2014年3月在洪澤縣人民醫院神經內科診斷的短暫性腦缺血髮作（ TIA）或腦梗死患者195例。迴顧性性分析患者的臨床資料、顱腦MRI檢查結果，採用Fazekas評分法分彆對側腦室徬LA和半卵圓中心LA進行嚴重程度分級，採用多因素Logistic迴歸分析篩選不同部位中重度LA的危險因素。結果側腦室徬無或輕度LA患者78例，側腦室徬中重度LA患者117例，不同嚴重程度側腦室徬LA患者年齡、高血壓髮生率、卒中史暘性率、顱外血管狹窄率及尿素、肌酐水平比較，差異有統計學意義（ P<0.05）；半卵圓中心無或輕度LA患者43例，半卵圓中心中重度LA患者152例，不同嚴重程度半卵圓中心LA患者年齡、高血壓髮生率、卒中史暘性率、顱外血管狹窄率及尿素水平比較，差異有統計學意義（P<0.05）。多因素Logistic迴歸分析結果顯示，高齡、高血壓、顱外血管狹窄是側腦室徬中重度LA的危險因素（P<0.05）；而高齡、高血壓、有卒中史是半卵圓中心中重度LA的危險因素（P<0.05）。結論中重度側腦室徬LA和半卵圓中心LA具有不同的危險因素，高齡、高血壓是LA最主要的危險因素，而顱外血管狹窄主要影響側腦室徬LA。
목적：탐토불동위치중중도뇌백질소송（ LA）적위험인소，이제고대해병적인식。방법선택2012년4월—2014년3월재홍택현인민의원신경내과진단적단잠성뇌결혈발작（ TIA）혹뇌경사환자195례。회고성성분석환자적림상자료、로뇌MRI검사결과，채용Fazekas평분법분별대측뇌실방LA화반란원중심LA진행엄중정도분급，채용다인소Logistic회귀분석사선불동부위중중도LA적위험인소。결과측뇌실방무혹경도LA환자78례，측뇌실방중중도LA환자117례，불동엄중정도측뇌실방LA환자년령、고혈압발생솔、졸중사양성솔、로외혈관협착솔급뇨소、기항수평비교，차이유통계학의의（ P<0.05）；반란원중심무혹경도LA환자43례，반란원중심중중도LA환자152례，불동엄중정도반란원중심LA환자년령、고혈압발생솔、졸중사양성솔、로외혈관협착솔급뇨소수평비교，차이유통계학의의（P<0.05）。다인소Logistic회귀분석결과현시，고령、고혈압、로외혈관협착시측뇌실방중중도LA적위험인소（P<0.05）；이고령、고혈압、유졸중사시반란원중심중중도LA적위험인소（P<0.05）。결론중중도측뇌실방LA화반란원중심LA구유불동적위험인소，고령、고혈압시LA최주요적위험인소，이로외혈관협착주요영향측뇌실방LA。
Objective To investigate the risk factors of moderate or severe leukoaraiosis in different lesion locations, to improve the awareness of clinicians. Methods A total of 195 patients with transient ischemic attack or cerebral infarction were selected in the People's Hospital of Hongze County from April 2012 to March 2014,and their clinical data and brain MRI findings were retrospectively analyzed,Fazekas score was used to judge the severity of periventricular leukoaraiosis and centrumsemioval leukoaraiosis,multivariate Logistic regression analysis was used to analyze the risk factors of moderate or severe leukoaraiosis in different lesion locations. Results Out of the 195 patients,78 cases occurred mild periventricular leukoaraiosis or were without periventricular leukoaraiosis(served as A group),117 cases occurred moderate or severe periventricular leukoaraiosis(served as B group);43 cases occurred mild centrumsemioval leukoaraiosis or were without centrumsemioval leukoaraiosis( served as C group),152 cases occurred moderate or severe centrumsemioval leukoaraiosis( served as D group). There were statistically significant differences of age,incidence of hypertension,positive rate of stroke history,extracranial vascular stenosis rate,urea nitrogen and creatinine between groups A and B(P <0. 05);and so were age,incidence of hypertension,positive rate of stroke history,extracranial vascular stenosis rate and urea nitrogen between groups C and D(P<0. 05). Multivariate Logistic regression analysis showed that, advanced age, hypertension, extracranial vascular stenosis were risk factors of moderate or severe periventricular leukoaraiosis(P<0. 05),while advanced age,hypertension,positive stroke history were risk factors of moderate or severe centrumsemioval leukoaraiosis ( P < 0. 05 ). Conclusion The risk factors of moderate or severe periventricular leukoaraiosis and centrumsemioval leukoaraiosis are different, advanced age, hypertension are the main risk factors of leukoaraiosis,while extracranial vascular stenosis mainly affects periventricular leukoaraiosis.
