不对称性脑白质疏松症的危险因素分析

The Analysis of the Risk Factor for Asymmetric Leukoaraiosis

目的分析不对称性脑白质疏松症的相关危险因素,探讨不对称性脑白质疏松症的患病率及发病机制。方法连续收集266例年龄40岁以上患者资料,所有患者行头颅MRI及颈动脉超声检查,依据头颅MRI诊断脑白质疏松症112例,依据MRI-FLAIR半定量分析方法计算白质高信号的体积并对腔隙性梗死灶计数,白质高信号重侧与轻侧比率>1.5 SD定义为双侧不对称。将脑白质疏松症患者分为对称性脑白质疏松症组和不对称性脑白质疏松症组,记录相关危险因素。结果不对称性脑白质疏松症共32例,患病率为12.03%。对称性脑白质疏松症与不对称性脑白质疏松症相比,年龄、高血压病史、糖尿病病史、颈动脉斑块或狭窄、脑梗死/TIA病史5个因素之间具有显著性差异;不对称性脑白质疏松症重侧与轻侧相关因素对比显示重侧腔隙性梗塞灶数量明显多于轻侧,重侧颈动脉斑块的Crouse积分明显高于轻侧。Binary Logistic回归分析显示,年龄、高血压病史、腔隙性脑梗死、颈动脉斑块或狭窄为不对称性脑白质疏松症的独立危险因素。结论不对称性脑白质疏松症的危险因素有年龄、高血压病史、腔隙性脑梗死、颈动脉斑块或狭窄。

Aim To analyze the risk factor of asymmetric leukoaraiosis（LA） and explore its incidence and its pathogenesis. Methods 266 consecutive patients elder than 40 years were included prospectively.Their clinical data were analyzed respectively.All of them had accepted a magnetic resonance lmaging（MRI） and a Ultrasonic examination.The white matter hyperintensities（WMH） volume of fluid attenuated inversion recovery（FLAIR） were quantified with a semi-automated method,Leukoaraiosis patients with a ratio of WMH volumes in heavy side and in light side 1.5 were considered as asymmetric LA,and numbers of lacunes were counted. Local factors were records for the analysis. Results 32 cases of asymmetric leukoaraiosis were found,the incidence of asymmetric LA was 12.03%.Comparing the risk factor of asymmetric LA patients and symmetric LA,the two groups had significant difference in age,history of hypertension,diabetes,carotid artery plaques/stenosis,ischemic stroke,and the heavy side of asymmetric LA had more lacunar infaction,higher Crouse scale.Binary Logistic regression showed age,history of hypertension,lacunar infarction and carotid artery plaques/stenosis were included in the model. Conclusion The risk factors for asymmetric LA are age,history of hypertension,lacunar infarction and carotid artery plaques/stenosis.