脑白质疏松与眼底血管病变的相关性分析

Correlation between leukoaraiosis and optical fundus vascular lesion

目的探讨脑白质疏松(leukoaraiosis,LA)与眼底血管病变的相关性。方法选择行头颅MRI和眼底检查的脑梗死患者168例,分为LA组108例和非LA组60例,比较2组临床资料,进行logistic回归分析。结果 LA组患者高血压、腔隙性脑梗死发生率及血浆同型半胱氨酸水平、C反应蛋白水平均高于非LA组,差异有统计学意义(P<0.05));LA组视网膜动静脉交叉征发生率为70.4%,蜡样渗出的发生率为31.5%,分别高于非LA组的38.3%和15.0%(P<0.05,P<0.01)。存在视网膜动静脉交叉征的患者LA发生率是无此症患者的4.14倍(OR=4.14,95%CI:1.67～10.28);存在蜡样渗出的患者LA的发生率是无蜡样渗出患者的1.81倍(OR=1.81,95%CI:0.56～5.87);年龄、高血压、腔隙性脑梗死是眼底血管病变的独立影响因素(OR=4.02,95%CI:1.59～10.13;OR=4.22,95%CI:1.93～25.94,P<0.05)。结论眼底视网膜病变中的动静脉交叉征和蜡样渗出是LA的危险因素。年龄、血压和腔隙性脑梗死与眼底病变及LA相关。

Objective To study the correlation between leukoaraiosis （LA） and optical fundus vas- cular lesion. Methods One hundred and sixty-eight ischemic stroke patients who underwent brain MRI and optial fundus examination were divided into LA group （n=108） and non-LA group （n= 60）. Their clinical data were analyzed by logistic regression analysis. Results The incidence of hypertension,lacunar infarction and plasma level of C reactive protein and homocysteine level were higher in LA group than in non-LA group （P〈0.05）. The incidence of retinal arteriovenous crossing sign and waxy exudates was significantly higher in LA group than in non-LA group （70.4% vs 38.33% ,31.5%vs 15.0% ,P〈0.05 ,P〈0.01）. The incidence of retinal arteriovenous crossing sign was 4. 14-fold higher in LA group than in non-LA group （OR= 4. 14,95%CI： 1.67-10.28）. The incidence of LA in patients with hard exudates was 1.81 times of those with- out hard e xudates （OR=I. 81,95%CI：0.56-5.87）. Age and hypertension were the independent factors for optical fundus vascular lesion （OR = 4.02,95 % CI ： 1.59 -10.13 ; OR = 3.22,95 % CI ： 1.93-25.87,P〈0.05）. Conclusion Optical fundus arteriolovenous crossing sign and waxy exu- date are the risk factor for LA. Age, hypertension and lacunar infarction are correlated with opti- cal fundus lesion and LA.