北京地区城市和乡村人群脑白质变性差异的研究

The study of difference of white matter degeneration between urban and rural population in Beijing

目的比较北京地区城市和乡村人群的脑白质变性程度的差异。材料与方法选取2012年12月至2014年2月于北京积水潭医院行脑MRI检查的居住于北京市内及乡村的中老年患者,排除DWI证实的及大面积的脑梗死、脑出血、脑积水和其他白质变性疾病,共82例：城市人41例,其中男13例,女28例,年龄56-72岁,平均（62.85±4.28）岁;乡村人41例,其中男17例,女24例,年龄56-69岁,平均（62.68±4.00）岁。使用Fazekas量表对脑白质变性评分。使用两组独立样本的t检验比较城市和乡村人群的年龄差异,χ2检验比较2组性别构成的差异。使用两组独立样本的秩和检验比较2组人群脑白质变性程度的差异,使用秩相关研究年龄与Fazekas量表总分的关系。结果 2组人群的年龄（t=0.187,P=0.852,P〉0.05）和性别（P=0.395,P〉0.05）构成均没有统计学差异,可排除年龄和性别因素对结果的影响。2组人群脑白质变性程度存在明显差异（Z=-2.730,P=0.006,P〈0.05）,北京地区乡村人群脑白质变性程度（总分的平均秩次为48.15）较城市人群（总分的平均秩次为34.85）严重。年龄与Fazekas量表总分存在相关性（r=0.484,P=0.000,P〈0.05）,脑白质变性随着年龄的增加而增重。结论北京地区乡村人群的脑白质变性程度较城市人群严重,将来发生认知障碍和脑血管事件的可能性较高,故需要给予乡村人群更多的重视。

Objective： To evaluate the difference of degree of white matter degeneration between urban and rural population in Beijing. Material and Methods： Except cerebral infarction（diagnosed by DWI）, hemorrhage, hydrocephalus and other white matter degeneration diseases, the MR image was obtained in a cohort of 41 urban [aged 56—72 years, mean age（62.85±4.28） years, 13 males and 28 females] and 41 rural patients [aged 56—69 years, mean age（62.68±4.00） years, 17 males and 24 females] who live in Beijing. The Fazekas scale was used to evaluate the degree of white matter degeneration. Independent-samples t test was made to exclude effect of age, and χ2 test was made to exclude the effect of gender. Independent-samples rank sum test was made to evaluate the difference of degree of white matter degeneration between urban and rural population. Rank correlation was made to evaluate the influence of age on total score according to the Fazekas scale. Results： There was statistically significant difference in degree of white matter degeneration between urban and rural population in Beijing（Z=-2.730, P=0.006, P〈0.05）. And the influence of age（t=0.187, P=0.852, P〈0.05） and gender（P=0.395, P〉0.05） can be excluded. The degree of white matter degeneration in rural population（mean rank 48.15） was more serious than that in urban population（mean rank 34.85）. There was correlation between age and total score（r=0.484, P=0.000, P〈0.05）. The degree of white matter degeneration increased with age. Conclusions： The degree of white matter degeneration in rural population in Beijing is more severe than that in urban population. Rural population in Beijing may have a greater possibility of cerebral vascular disease and cognitive disorder. Therefore, more attention should be paid to rural population.