伴有脑白质疏松的动脉粥样硬化性血栓性脑梗死患者危险因素分析

The clinical analysis of risk factors in atherothrombotic cerebral infarction patients with leukoaraiosis

目的以动脉粥样硬化性血栓性脑梗死患者(atherothrombotic cerebral infarction,ATCI)为对象,分析伴有和不伴有脑白质疏松(leukoaraiosis,LA)的ATCI患者危险因素的差异,探讨LA发生的机制。方法经头颅MRI证实ATCI患者253例,分为动脉粥样硬化性血栓性脑梗死不伴脑白质疏松组(A组,174例)和伴有脑白质疏松组(B组,79例)。对患者的性别、年龄、血小板计数、白细胞计数、空腹血糖、肌酐、血脂、高血压病史、脑梗死病史等多种危险因素进行单因素分析及logistic回归分析。结果 A组174例(68.77%),平均年龄(59.9±13.3)岁;B组79例(31.23%),平均年龄(67.5±11.0)岁。牛津郡社区卒中计划(OCSP)分型:A组1型30例,2型75例,3型31例,4型38例;B组1型6例,2型38例,3型7例;4型28例。Pearson、spearman单因素分析入选因素:年龄(P=0.000),空腹血糖(P=0.005),OCSP分型(P=0.014),其中4型腔隙性脑梗死P=0.022。logistic多因素回归分析最终入选模型的变量是年龄(P=0.000)、OCSP分型(P=0.035),其中4型腔隙性脑梗死P=0.019。结论高龄、OCSP脑梗死类型提示的病变部位对动脉粥样硬化性血栓性脑梗死患者是否伴发LA有独立的相关性。

Objective To compare the differences of risk factors between atherothrombotic cerebral infarction（ATCI） patients with and without leukoaraiosis（LA）,aimed to explore the pathogenesis of LA.Methods 253 patients with ATCI underwent by MRI scans were divided into two groups（with and without LA）.The ATCI was verified by DWI sequences and the LA was detected by FLAIR sequences.The risk factors（sexuality,age,platelet count,numeration of leukocyte,FPG,creatinine,e.g.） in patients without LA（A group） were compared with the patients with LA（B group）.Results There were 174 cases（68.77%） in group A,with an average age of（59.9±13.3） years.There were 79（31.23 %）cases in group B,with an average age of（67.5±11.0） years.There was a significant correlation between the LA and age,OCSP typing（Lacunar infarction）.In logistic regression analysis age,OCSP typing（Lacunar infarction）were included in the model.Conclusions Older age,OCSP typing（Lacunar infarction） are related to LA in ATCI patients,are the independent risk factors to LA.