急性腔隙性脑梗死患者血管周围间隙扩大程度的影响因素研究

Influence factors of degrees of Virchow-Robin spaces in acute lacunar stroke patients

目的探讨基底节区、半卵圆中心急性腔隙性脑梗死患者血管周围间隙（VRS）扩大程度的影响因素。方法收集运城市中心医院神经内科自2016年1月至2017年6月收治的238例基底节区、半卵圆中心急性单发腔隙性脑梗死患者（基底节区梗死患者131例，半卵圆中心梗死患者107例1的临床资料，使用MRI对患者VRS扩大程度进行评价，采用单因素分析及多因素Logistic回归分析探讨基底节区血管周围间隙（BG-VRS）、半卵圆中心血管周围间隙（CSO-VRS）扩大程度的影响因素。结果基底节区梗死患者与半卵圆中心梗死患者BG—VRS、CSO-VRS分级评分比较差异均无统计学意义（P〉0．05）。单因素分析显示，BG-VRS轻度扩大组与BG-VRS重度扩大组在性别分布、高血压比例、收缩压水平及体质量指数（BMI）方面比较差异均有统计学意义（P〈0．05）．CSO．VRS轻度扩大组与CSO．VRS重度扩大组在高血压比例、糖尿病比例、BMI方面比较差异均有统计学意义（P〈0．05）。多因素Logistic回归分析显示，高血压、BMI对BG—VRS扩大程度有显著影响（OR=6．272，95％CI：1．931-20．365，P=-0．002；OR=0．757，95％CI：0．619-0．927，P=-0．007），而BMI对CSO．VRS扩大程度有显著影响（OR=0．775，95％CI：0．655-0．918，P=-0．004）。结论高血压是BG-VRS扩大程度的危险因素，BMI是BG-VRS、CSO-VRS扩大程度的保护因素。

Objective To investigate the influence factors of degrees of Virchow-Robin Spaces （VRS） in patients with acute first-ever lacunar stroke. Methods Two hundred and thirty-eight patients with first-ever lacunar stroke whose infractions were found in the basal ganglia （n=131） or the central semiovale （n=107） were recruited from our hospital from January 2016 to June 2017. The demographic and clinical characteristics of these patients were collected and magnetic resonance imaging was used to identify the presence and degrees of VRS in the basal ganglia （BG-VRS） and central semiovale （CSO-VRS）. Logistic regression models were constructed to identify the influence factors for BG-VRS and CSO-VRS. Results The VRS scores were not statistically different between patients whose infractions were found in basal ganglia and patients whose infractions in central semiovale （P〉0.05）. Univariate survival analysis indicated that gender, hypertension percentage, systolic pressure level, and body mass index （BMI） in patients from mild BG-VRS group were significantly different as compared with those in patients from severe BG-VRS group （P〈0.05）; hypertension percentage, diabetes mellitus percentage, and BMI in patients from mild CSO-VRS group were significantly different as compared with those in patients from severe CSO-VRS group （P〈0.05）. Multivariable Logistic regression analysis showed that hypertension and BMI could significantly influence the severity of BG-VRS （odds ratio [OR] =6.272, 95% confidence interval [CI]： 1.931-20.365, P=-0.002; OR=0.757, 95%CI： 0.619-0.927, P=- 0.007）, and BMI could significantly influence the severity of CSO-VRS （OR=0.775, 95%CI： 0.655-0.918, P=0.004）. Conclusion Hypertension is the independent risk factor of degrees of BG-VRS, and BMI is the protective factor of degrees of BG-VRS and CSO-VRS.