缺血性卒中患者脑微出血的危险因素分析

Analysis of risk factors for cerebral microbleeds in patients with ischemic stroke

目的探讨缺血性卒中患者发生脑微出血（CMBs）的危险因素。方法前瞻性连续纳入2012年1月至2014年1月于北京军区总医院住院的缺血性卒中患者184例,根据头部MRI磁敏感加权成像（SWI）显示有无CMBs,分为CMBs组60例和无CMBs组124例。收集两组患者的一般临床资料、血清生化结果,计算肾功能肌酐清除率（Ccr）,并对两组资料进行单因素和多因素分析。结果 （1）单因素分析结果显示,CMBs组与无CMBs组年龄[（63±10）岁比（58±10）岁]、男性患者比率[65.0%（39/60）比49.2%（61/124）]、脑白质疏松（LA）发生率[73.3%（44例）比47.6%（59例）]及血清同型半胱氨酸（Hcy）水平[（20±8）μmol/L比（16±6）μmol/L]比较,差异有统计学意义（P〈0.05）;CMBs组Ccr水平[（89±10）ml/（min·1.73 m2）]低于非CMBs组[（106±6）ml/（min·1.73 m2）],差异有统计学意义（P〈0.05）。（2）多因素Logistic回归分析显示,年龄（OR=1.103,95%CI：1.024~1.989,P=0.028）、LA（OR=3.121,95%CI：1.310~7.436,P〈0.05）、肾功能异常（OR=1.890,95%CI：1.358~3.076,P〈0.01）是缺血性卒中患者发生CMBs的独立危险因素。结论年龄、LA及肾功能异常是缺血性卒中患者发生CMBs的独立危险因素。

Objective To investigote the risk factors for occurring cerebral microbleeds （CMBs） in patients with ischemic stroke Methods A total of 184 consecutive patients with ischemic stroke admitted from January 2012 to January 2014 in General Hospital of Beijing Military Command were enrolled prospec- tively. They were divided into either a CMB group （n = 60） or a non-CMB group （n = 124） according to whether head MRI magnetic sensitive weighted imaging （SWI） revealed CMBs or not. The general clinical data and serum biochemical results of the patients in both groups were collected. Renal creatinine clearance （Ccr） was calculated,and the data of both groups were analyzed by the univariate and multivariate analyses. Results （ 1 ） The results of univariate analysis showed that there were significant differences in age （63 ± 10 vt. 58 ± 10）, male （ 65.0% [ 39/60 ] vs. 49. 2% [ 61/124 ] ）, the incidence of leukoaraiosis （LA） （73.3% [44cases] vs. 47.6% [59cases] ） ,and serum homocysteine （Hcy） levels （20 ±8 vs. 16 ± 6 μmol/L） between the CMB group and the non-CMB group （P 〈0.05）. The Ccr level （89 ± 10mL/ （min · 1.73 m2 ） of the CMB group was lower than （ 106 ± 6 mL/（ min · 1.73 m2 ） of the non-CMB group. There was significant difference （P 〈 0. 05 ）. （2） Multivariate logistic regression analysis showed that age（OR,1. 103,95% CI1. 024-1. 989,P =0. 028） ,LA （0R,3. 121,95% CI 1. 310-7.436;P 〈 0. 05） and impaired kidney function （OR, 1. 890,95% CI 1. 358 -3. 076 ;P 〈 0. 01 ） were the independent risk factors for the occurrence of CMBs in patients with ischemic stroke. Conclusion Age,LA and impaired kidney function are the independent risk factors for occurring CMBs in patients with ischemic stroke.