138例无症状性脑梗死患者临床特点及危险因素分析

Clinical features and risk factors of silent cerebral infarction： an analysis of 138 patients

目的探讨无症状性脑梗死（sci）的临床特点、危险因素及性别差异，为卒中的一级预防及二级预防提供临床依据。方法选择邢台市人民医院神经内科及康复科自2010年1月至2013年1月收治的356例住院患者进行研究，将其中经头颅MRJ检查确诊的138例SCI患者定义为观察组．218例非SCI患者定义为对照组。分析2组患者影像学及临床特点，同时对2组患者年龄、性别、血压、血糖、甘油三酯（TG）、低密度脂蛋白（LDL）等指标进行统计学分析以确定SCI的危险因素。再将SCI患者按性别区分，分析高危因素在不同性别患者之间的差异。结果（1）SCI的病灶以腔隙性病灶为主，主要位于基底节区、放射冠区，多为多发病灶。（2）Logistic回归分析显示SCI的独立危险因素为年龄、高血压、冠心病、糖尿病、高TG、高LDL及吸烟。（3）与男性SCI患者相比，女性SCI患者糖尿病、冠心病的发生率较高，高TG、吸烟发生率较低，差异有统计学意义（P〈0．05）。结论SCI具有明确的独立危险因素，且存在性别差异。

Objective To explore the clinical features, risk factors and gender differences of silent cerebral infarction （SCI）, and provide the clinical basis for the primary and secondary preventions. Methods Three hundred and fifty-six patients without previous history of stroke and neurological signs, admitted to our hospital from January 2010 to January 2013, were selected and divided to 2 groups： an observation group （n=138, having SCI） and a control group （n=218, not having SCI）. Age, gender, levels of blood pressure, blood glucose, triglyceride, low density lipoprotein （LDL） and total cholesterol, smoking history, drinking history, family history of stroke, and coronary heart disease history were analyzed by single and multiple factor Logistic analysis. SCI patients were divided into male SCI group and female SCI group to compare the differences of high risk factors. Results SCI lesions mainly located in the basal ganglia and crown areas of radiation, which were mainly multiple lesions. Logistic regression analysis showed that independent risk factors were age, hypertension, coronary heart disease history, diabetes history, high triglyceride and high LDL levels, and smoking history. The incidences of diabetes and coronary heart disease in female SCI patients were significantly higher than those in male SCI patients （P〈0.05）, and those of high triglyceride and smoking in SCI female patients were statistically lower than those in male SCI patients （P〈0.05）. Conclusion Risk factors of SCI include age, hypertension, coronary heart disease history, diabetes, high triglyceride and high LDL levels, and smoking; and gender differences exist in these risk factors.