血管性帕金森综合征相关因素的研究

Studies on relative factors of vascular parkinsonism

目的探讨影响血管性帕金森综合征(VP)发生的相关因素。方法选择首发脑梗死患者425例,将最终进入研究队列的404例患者按牛津郡社区脑卒中规划(OCSP)分型分为4组,完全前循环梗死组(30例)、部分前循环梗死组(135例)、腔隙性脑梗死组(206例)和后循环梗死组(33例)。随访4年,记录终点事件。采用logistic回归模型进行危险因素分析。结果发生VP终点事件者54例,发病率为13.4%。腔隙性脑梗死组VP发病率最高。为42例(20.4%);VP的发生在年龄、高血压史、全血还原比黏度、纤维蛋白原方面差异有统计学意义(P<0.05,P<0.01)。结论腔隙性脑梗死容易导致VP的发生;年龄、高血压史、全血还原比黏度、纤维蛋白原是VP发生的危险因素。

Objective To investigate the relative factors of vascular parkinsonism（VP） ,in order to provide a clinical basis for early diagnosis of VP. Methods The method of prospective cohort study was used. The first cerebral infarction was taken as the initiating event. All the cases were followed up for 4 years. When they suffered from VP or died of VP, the follow-up was terminated. Logistic regression model was used to analyze the risk factors for VP. Results Fifty-four patients developed VP in 404 patients with first cerebral infarction,the incidence rate was 13.4%. According to the typing standard of OCSP,in the 404 patients,the incidence of VP was highest in lacunar infarction group（42 cases, 20. 4%）. The main risk factors for VP included age （P = 0. 043, OR = 1. 135,95% CI= 1. 010-1. 275）,hypertension history （P = 0. 032, OR =2. 019, 95G CI ： 1. 247-4. 746） ,blood viscosity （P = 0. 041, OR = 1. 724,95% CI ： 1. 036-3. 058） and fibrinogen （P = 0. 001, OR =2. 241,95% CI： 1. 272-5. 473）. Conclusion During follow-up for 4 years,the incidence rate of VP in patients with first cerebral infarction is 13.4%. Lacunar infarction is apt to cause occurrence of VP. Age, hypertension history, blood viscosity and fibrinogen are risk factors for VP. VP may be caused by multiple factors and multiple mechanisms.