高龄脑白质疏松患者的临床表现与危险因素分析

Analysis of Clinical Manifestations and Risk Factors in Senile Patients with Leukoaraiosis

【目的】探讨高龄脑白质疏松（L A ）患者的临床表现，分析其相关危险因素，为临床研究提供依据。【方法】采用回顾性研究方法共纳入45例入住本院诊断为L A的高龄患者作为观察组，同时随机抽取无 L A的高龄人群75例作为对照组，详细记录其相关信息及临床症状，应用多因素回归分析进行相关危险因素分析。【结果】LA患者随年龄的增加，LA严重程度越重，且有不同程度认知功能障碍表现，重度组认知功能障碍最严重，临床痴呆评定量表（CDR）评分最高，简易精神状态量表（MMSE）评分最低，与轻、中度相比差异有显著性（ P ＜0．05）；中度组认知功能障碍较轻度组严重，CDR评分高于轻度组，MMSE评分低于轻度组（ P＜0．05）。单因素分析显示高血压病史、糖尿病史、吸烟史、饮酒史、脑血管病史与LA的发生存在密切的相关性，两组间比较差异有显著性（ P ＜0．05）；而两组间血脂、空腹血糖（FBG）、同型半胱氨酸（Hcy）比较差异无显著性（ P ＞0．05）。多因素分析显示高血压病史、饮酒史、脑血管病史是LA 发生的独立危险因素（ P ＜0．05）。【结论】高龄人群发生LA与既往高血压病史、饮酒史、脑血管病史存在密切的相关性，是其发生的独立危险因素。

[Objective] To explore clinical manifestations and risk factors in senile patients with leukoarai‐osis（LA） so as to provide the basis for clinical research .[Methods] A total of 45 senile patients with LA in our hospital were enrolled in the study and selected as observation group by using retrospective method .Mean‐while ,75 patients without LA were randomly selected as control group .The relevant information and clinical symptoms were recorded in detail .Multiple factor regression method was used to analyze the relevant risk fac‐tors .[Results]The severity of LA patients was increased with the age .Different degree of cognitive dysfunc‐tion appeared in LA patients .The severe group had the most serious cognitive dysfunction ,the highest CDR scores and the lowest MMSE scores ,and there were significant differences between the severe group and mild or moderate groups（ P 〈0 .05） .Univariate analysis showed that the history of hypertension ,diabetes melli‐tus ,smoking ,drinking and cerebrovascular disease were closely correlated with the incidence of LA ,and there was significant difference between two groups （ P〈0 .05） ,but there was no significant difference in blood lip‐ids ,fasting blood glucose（FBG） and homocysteine（Hcy） between two groups（ P 〉0 .05） .Multiple factor a‐nalysis showed that the history of hypertension ,drinking and cerebrovascular disease were independent risk factors of LA（ P〈0 .05） .[Conclusion] The incidence of LA in senile population is closely correlated with the history of hypertension ,drinking and cerebrovascular disease ,which are the independent risk factors of LA .