老年脑白质疏松与脑血管狭窄的相关性研究

Relationship between leukoaraiosis and cerebrovascular stenosis in elderly subjects

目的 探讨老年脑白质疏松（LA）与脑血管狭窄的相关性.方法 连续回顾性分析同期行头颅MRI及脑血管造影检查的短暂性脑缺血发作或脑梗死患者333例.采用Fazekas分级法分别对侧脑室旁LA和半卵圆中心LA进行程度分级：0级或1级为无或轻度LA,2级或3级为中重度LA.基于侧脑室旁LA严重程度分为无或轻度LA组206例,中重度LA组127例;基于半卵圆中心LA严重程度分为无或轻度LA组270例,中重度LA组63例.分别探讨侧脑室旁LA及半卵圆中心LA与脑血管狭窄的相关性.结果 侧脑室旁LA：与无或轻度LA组比较,中重度LA组年龄、高血压、脑卒中、颅外动脉狭窄及前循环狭窄差异有统计学意义（P＜0.05）;半卵圆中心LA：与无或轻度LA组比较,中重度LA组年龄、高血压、糖尿病、脑卒中、颅外动脉狭窄、前循环狭窄差异有统计学意义（P＜0.05）.校正非血管性危险因素后,logistic回归分析显示,侧脑室旁LA与颅外动脉狭窄（OR=1.653,95%CI：1.017~2.686,P=0.042）独立相关,半卵圆中心LA与颅外动脉狭窄无相关性（OR=1.594,95%CI：0.882~2.879,P=0.123）.结论 颅外动脉狭窄对侧脑室旁白质是否发生LA改变有独立的相关性.

Objective To study the relationship between leukoaraiosis （LA） and cerebrovascular stenosis in elderly subjects. Methods Clinical data about 333 patients who underwent head MRI and angiography in our hospital for transient ischemic attack or stroke were retrospectively ana- lyzed. The patients were divided into non- or mild lateral ventricular LA group （n：206） and mod- erate severe lateral ventricular LA group （n= 127）,non- or mild central semioval LA group （n： 270） and moderate-severe central semioval LA group（n= 63）. Relationship of lateral ventricular IrA and central semioval LA with cerebrovascular stenosis was analyzed. Results The age was ol- der and the incidence of hypertension, diabetes mellitus, ischemic stroke, extracranial artery steno sis and anterior circulation stenosis was significantly lower in non- or mild lateral ventricular LA group than in moderate/severe lateral ventricular LA group （P〈0.05） and in non- or mild central semioval LA group than in moderate-severe central semioval LA group（P〈0.05）. Logistic re- gression analysis showed that extracranial ortery stenosis was the independent risk factor for lat- eral ventricular LA rather than for central semioval LA （OR ： 1.653,95 % CI ： 1.017 - 2.686, P = 0. 042;OR=1. 594,95%CI：0. 882-2. 879,P：0.123）. Conclusion Extracranial athery stenosis is an independent risk factor for lateral ventricular LA in elderly subjects.