脑白质疏松症严重程度与其发生的相关因素分析

Correlation between severity of leukoaraiosis and its related factors

目的评价脑白质疏松症(LA)临床相关危险因素之间的相关性及预测病情的价值。方法回顾性调查行头颅MRI检查的住院患者218例,根据诊断分为非LA 56例和LA 162例,LA患者又根据Fazekas等级分类标准,分为轻度LA 52例,中度LA 53例及重度LA 57例。对相关危险因素(年龄、性别、既往疾病、血脂等)分别进行逐个单因素和多因素logistic回归分析。结果 TC、高LDL-C、高同型半胱氨酸与轻度LA发生有相关性(P<0.05,P<0.01)。年龄≥70岁、高血压3级、吸烟、高TC,高同型半胱氨酸与中度LA的发生有相关性(P<0.05,P<0.01)。年龄≥70岁、高血压3级、高LDL -C、高同型半胱氨酸、颈动脉内膜中层厚度增厚与重度LA的发生有相关性(P<0.05)。结论年龄≥70岁、高血压3级、高同型半胱氨酸、高TC、高LDL-C、吸烟及颈动脉内膜中层厚度增厚是LA的独立发病危险因素。中度LA和重度LA与年龄≥70岁、高血压3级及颈动脉内膜中层厚度增厚有明显相关性。

Objective To assess the correlation between leukoaraiosis（LA）-related risk factors and its value in predicting the condition of LA. Methods Two hundred and eighteen patients admitted to our hospital for cranial MRI were divided into non-LA group（n=56） and LA group（n=162）. Patients in LA group were further divided into mild LA group （n =52）, moderate LA group （n = 53） ,and severe LA group（n=57） according to the Fazekas classification. Their relative risk fac- tors, including age, gender, history of disease, and blood-lipid, were analyzed by single and multi- factorial logistic regression analysis. Results The TC,LDL-C and high homocysteine were related with mild LA（P〈 0.05, P〈 0.01）. Age ≥ 70 years, hypertension grade 3, smoking, high choles- terol and high homocysteine were related with moderate LA（P〈0. 05, P〈0. 01）. Age ≥70 years,hypertension grade 3, LDL-C, high homocysteine and carotid intima-media thickness were related with severe LA（P〈0.05,P〈0.01）. Conclusion Age≥70 years,hypertension grade 3, high homocysteine,TC, LDL-C and carotid intima-media thickness are the independent risk fac- tors for LA. Moderate and severe LA are closely related with age ≥70 years,hypertension grade 3 and carotid intima-media thickness.