CAJ | 학술논문

目的：观察和分析脑梗死（CI）患者并发脑白质疏松（LA）的危险因素分析及与全身炎症反应的关系。方法：选取200例CI患者作为研究对象，根据是否合并LA将其分为LA组（93例）和非LA组（107例）。对两组患者的年龄、性别、既往史、血压水平、血脂水平、血糖水平、血浆脂蛋白相关磷脂酶A2（Lp-PLA2）水平、血清超敏C反应蛋白（hs-CRP）水平、血清白细胞介素10（IL-10）水平及全身炎症反应综合征（SIRS）的发生率进行观察和比较。结果：两组患者在年龄、腔隙性脑梗死史、高血压比例、入院时收缩压、血浆Lp-PLA2水平、SIRS比例、血清hs-CRP水平、血清IL-10水平方面的差异均有统计学意义；Logistic多元回归分析结果显示，CI合并LA的发生与年龄（OR=1.657）、腔隙性脑梗死史（OR=2.368）、血浆Lp-PLA2水平（OR=2.366）、SIRS（OR=3.067）、血清hs-CRP水平（OR=2.187）和血清IL-10水平（OR=0.469）具有相关性；在剔除年龄、腔隙性脑梗死史等因素后，Logistic多元回归分析结果显示，CI合并LA的发生与血浆Lp-PLA2水平（OR=2.045）、SIRS（OR=2.533）、血清hs-CRP水平（OR=1.745）和血清IL-10水平（OR=0.665）具有相关性。结论：CI患者并发LA与多种危险因素有关，全身性炎症反应在LA的发病中发挥着重要的作用，临床医生应对高危因素给予充分重视和及时干预，以达到提高治疗效果、改善患者预后的目的。
목적：관찰화분석뇌경사（CI）환자병발뇌백질소송（LA）적위험인소분석급여전신염증반응적관계。방법：선취200례CI환자작위연구대상，근거시부합병LA장기분위LA조（93례）화비LA조（107례）。대량조환자적년령、성별、기왕사、혈압수평、혈지수평、혈당수평、혈장지단백상관린지매A2（Lp-PLA2）수평、혈청초민C반응단백（hs-CRP）수평、혈청백세포개소10（IL-10）수평급전신염증반응종합정（SIRS）적발생솔진행관찰화비교。결과：량조환자재년령、강극성뇌경사사、고혈압비례、입원시수축압、혈장Lp-PLA2수평、SIRS비례、혈청hs-CRP수평、혈청IL-10수평방면적차이균유통계학의의；Logistic다원회귀분석결과현시，CI합병LA적발생여년령（OR=1.657）、강극성뇌경사사（OR=2.368）、혈장Lp-PLA2수평（OR=2.366）、SIRS（OR=3.067）、혈청hs-CRP수평（OR=2.187）화혈청IL-10수평（OR=0.469）구유상관성；재척제년령、강극성뇌경사사등인소후，Logistic다원회귀분석결과현시，CI합병LA적발생여혈장Lp-PLA2수평（OR=2.045）、SIRS（OR=2.533）、혈청hs-CRP수평（OR=1.745）화혈청IL-10수평（OR=0.665）구유상관성。결론：CI환자병발LA여다충위험인소유관，전신성염증반응재LA적발병중발휘착중요적작용，림상의생응대고위인소급여충분중시화급시간예，이체도제고치료효과、개선환자예후적목적。
ObjectiveTo observe and analyze the analysis on the risk factors of application with leukoaraiosis (LA) of the patients with cerebral infarction (CI) and its relationship with systemic inflammatory response.Methods 200 cases of CI pa-tients were selected as the research objects and divided into LA group (93 cases) and non LA group (107 cases) according to the complication of LA. The age, the gender, the medical history, the blood pressure, the lipid level, the blood glucose level, the plasma lipoprotein associated phospholipase A2 (Lp-PLA2), the serum high sensitive C reactive protein (hs-CRP) level, the level of serum interleukin 10 (IL-10) and the incidence of systemic inflammatory response syndrome (SIRS) of the patients in the two groups were observed and compared.Results There were statisticaly significant differences of the age, the ratio of hy-pertension, the ratio of lacunar infarction history, the systolic blood pressure on the admission, the plasma Lp-PLA2 level, the incidence of SIRS, the serum hs-CRP level, the serum IL-10 level of the patients between the two groups; Multivariate Logistic regression analysis showed that the incidence of CI complicated with LA was correlated with the age (OR=1.657), the lacunar infarction history (OR=2.368), the plasma Lp-PLA2 level (OR=2.366), the incidence of SIRS (OR=3.067), the serum hs-CRP level (OR=2.187) and the serum IL-10 level (OR=0.469); After the elimination of the age, the lacunar infarction history, the multivariate Logistic regression analysis showed that the incidence of CI complicated with LA was correlated with the plasma Lp-PLA2 level (OR=2.045), the incidence of SIRS (OR=2.533), the serum hs-CRP level (OR=1.745) and the serum IL-10 level (OR =0.665).Conclusions The incidence of complication with LA in the patients with CI was correlated with various risk factors. The systemic inflammatory response plays an important role in the pathogenesis of LA. The clinicians should pay more attention to the risk factors and employ the timely intervention so as to achieve the purpose of improving the treatment effects and the prognosis of the patients.