急性脑梗死患者脑微出血的发病情况及其危险因素分析

Prevalence and risk factors of cerebral microbleeds in patients with acute cerebral infarction

目的探讨急性脑梗死患者脑微出血的发病情况及其危险因素。方法选择急性脑梗死患者75例,男51例,女24例,年龄42~83(64.9±10.8)岁。行头颅CT、磁敏感成像(SWI)检查,依据脑微出血检出的结果分成阳性组(23例)与阴性组(52例),比较两组的一般资料,探讨脑微出血发病的危险因素。结果SWI检查的检出率比CT检出率高(x^2=27.17,P<0.05)。阳性组年龄、高血压病、糖尿病患病率均较阴性组高,差异均有统计学意义(均P<0.05);两组性别、血脂异常、心房颤动、冠心病、吸烟、饮酒情况比较,差异均无统计学意义(均P>0.05)。logistic回归分析显示年龄增长、高血压病是脑微出血的独立危险因素(P<0.05)。结论急性脑梗死患者合并存在脑微出血的比例高,SWI检查是检测脑微出血的敏感方法,年龄大、高血压病与脑微出血的发生密切相关。

Objective To assess the prevalence and risk factors of cerebrat microbteeds （CMBs） in patients with acute cerebral infarction. Methods Seventy five patients with acute cerebral infarction, including 51 males and 34 females with a mean age of 64.9± 10.8 years （42- 83y）, were recruited in the study. The demographic information and detailed medical history were documented, and cranial CT and susceptibility weighted imaging （SWI） examinations were performed. The risk factors of CMBs were analyzed with multivariate logistic regression. Results The detection rate of CMBs by SWI was higher than that by CT scan （P〈0.05）. Among 75 patients, CMBs were detected in 23 cases with a prevalence rate of 30.7%. The proportions of older age, hypertension and diabetes were significantly higher in CMB patients than those in non-CMB patients （P〈0.05）; however, there were no significant differences in sex, dyslipidemia, atrial fibrillation, coronary heart disease, smoking and drinking between two groups （P 〉0.05）. Multivariate logistic regression showed that advanced age and hypertension were independent risk factors for CMBs （P〈0.05）. Conclusion The prevalence of CMBs in patients with acute cerebral infarction is high, SWI is more sensitive to detect SMBs than CT scan, and advanced age and hypertension are closely related to the occurrence of CMBs.