CAJ | 학술논문

目的分析与无症状性腔隙性梗死严重程度相关的危险因素，并评价无症状性腔隙性梗死与缺血性卒中病因亚型的相关性。 　　方法连续选取791例7天以内首次发病的非心源性缺血性卒中患者。收集患者的人口学信息和血管病的危险因素，评价患者的头颅磁共振成像包括无症状性腔隙性梗死的数量、脑白质疏松的严重程度、缺血性卒中的病因亚型以及急性梗死灶的分布特征，并通过多元Logistic回归分析其与无症状性腔隙性梗死相关的危险因素。 　　结果296例患者（37.4%）伴无症状性腔隙性梗死。单因素分析发现：高龄、高血压、入院时血压较高、糖尿病、脑出血病史、Fazekas评分≥3分、小动脉闭塞性卒中、单发梗死灶、无小的皮层梗死灶、无分水岭梗死和流域性梗死与无症状性腔隙性梗死患病相关。多元Logistic回归发现：男性、高血压、较高的舒张压、糖尿病、脑出血病史、Fazekas评分≥3分、小动脉闭塞性卒中是无症状性腔隙性梗死患病的危险因素。 　　结论首发非心源性缺血性卒中患者无症状性腔隙性梗死的患病率较高。伴无症状性腔隙性梗死的首发非心源性缺血性卒中患者常有较重的脑白质疏松，并且所患缺血性卒中以小动脉闭塞性卒中常见。
목적분석여무증상성강극성경사엄중정도상관적위험인소，병평개무증상성강극성경사여결혈성졸중병인아형적상관성。 　　방법련속선취791례7천이내수차발병적비심원성결혈성졸중환자。수집환자적인구학신식화혈관병적위험인소，평개환자적두로자공진성상포괄무증상성강극성경사적수량、뇌백질소송적엄중정도、결혈성졸중적병인아형이급급성경사조적분포특정，병통과다원Logistic회귀분석기여무증상성강극성경사상관적위험인소。 　　결과296례환자（37.4%）반무증상성강극성경사。단인소분석발현：고령、고혈압、입원시혈압교고、당뇨병、뇌출혈병사、Fazekas평분≥3분、소동맥폐새성졸중、단발경사조、무소적피층경사조、무분수령경사화류역성경사여무증상성강극성경사환병상관。다원Logistic회귀발현：남성、고혈압、교고적서장압、당뇨병、뇌출혈병사、Fazekas평분≥3분、소동맥폐새성졸중시무증상성강극성경사환병적위험인소。 　　결론수발비심원성결혈성졸중환자무증상성강극성경사적환병솔교고。반무증상성강극성경사적수발비심원성결혈성졸중환자상유교중적뇌백질소송，병차소환결혈성졸중이소동맥폐새성졸중상견。
Objective To investigate the risk factors of silent lacunar infarction(SLI), and analyze the relationship between SLI and the etiologic subtype of ischemic stroke. Methods Over all, 791 patients within 7 days of their ifrst-ever non-cardiogenic ischemic stroke were enrolled consecutively. Demographic information, vascular risk factors were recorded. We evaluated cranial magnetic resonance imaging including number of SLI, severity of leukoaraiosis, etiologic subtype of ischemic stroke, and topographic patterns of acute cerebral infarcts. Factors associated with the presence of SLI were analyzed. Results A total of 296 patients (37.4%) had SLI. In univariate analysis, older age, hypertension, higher admission blood pressure, diabetes, history of cerebral hemorrhage, Fazekas scores ≥3, ischemic stroke due to small artery occlusion(SAO), single infarct, absence of small cortical infarct, absence of watershed infarcts and absence of territorial infarctwere signiifcantly associated with the presence of SLI. In multivariable logistic regression analysis, male, hypertension, higher diastolic blood pressure, diabetes, history of cerebral hemorrhage, Fazekas scores ≥3, and SAO subtype stroke were signiifcantly associated with the presence of SLI. Conclusion First-ever non-cardiogenic ischemic stroke patients with SLI often have severe leukoaraiosis and more often suffer from SAO subtype stroke than those without SLI.