非糖尿病患者脑白质病变危险因素研究

Risk factors of white matter lesions in non-diabetic patients

目的探讨非糖尿病患者脑白质病变（wML）的相关危险因素。方法选择中国医科大学附属盛京医院神经内科自2010年10月至2011年10月收住院的非糖尿病患者86例，均行头部MⅪ检查，根据国际通用的Aharon-PeretzJ分级标准进行WML程度分级．将患者分为2组：WML分级≥1级（50例）作为病例组，WML分级=0级（36例）作为对照组。采集一般临床资料，包括性别、年龄、高血压病史、空腹血糖、餐后2h血糖、空腹胰岛素、尿酸、胆红素、血脂、糖化血红蛋白等指标及头部MRJ影像学资料，研究非糖尿病患者WML的相关危险因素。结果年龄、高血压病史、空腹胰岛素水平、低密度脂蛋白及胰岛素抵抗指数在病例组和对照组之间比较差异有统计学意义（P〈0．05）。多因素Logistic回归分析显示WML的独立影响因素是年龄[OR值为1．1（95％CI：1．0～1．1，P=-0．012）]、高血压病史[OR值为2．2（95％CI：0．7～7．0，P=-0．027）1及胰岛素抵抗指数[OR值为3．1（95％CI：1．5-6．2，P=0．002）]。结论年龄、高血压病史、胰岛素抵抗指数是非糖尿病患者WML的重要危险因素。

Objective To determine the risk factors of white matter lesions （WML） in non-diabetic patients. Methods Eighty-six non-diabetic patients, admitted to our hospital from October 2010 to October 2011, were included in the study. MRI was performed on these patients for WML, and they were classified into two groups according to the Aharon-Peretz J grading of WlvlL： WML positive group （n=50） and WML negative group （control group, n=36）. The clinical data of these patients, including gender, age, history of hypertension, and levels of fasting plasma glucose, 2 h postprandial blood glucose, fasting insulin, uric acid, bilirubin, blood lipids and glycosylated hemoglobin, and MR imaging data were collected. Results No statistically significant differences were found in the possible risk factors of WML, except for hypertension history （P=-0.00）, age （P=-0.00）, low-density lipoprotein level （P=-0.00） and insulin resistance （IR, P=-0.00）. Multivariate logistic regression analysis indicated that the significant important risk factors of WML included age, hypertension history and IR, and their OR values were 1.1 （95%CI： 1.0-1.1, P=-0.012）, 2.2 （95%CI： 0.7-7.0, P=-0.027） and 3.1 （95%CI： 1.5-6.2, P=- 0.002）, respectively. Conclusion Age, hypertension history and IR are the important risk factors for WML in non-diabetic patients.