脑微出血在脑梗死早期复发风险预测价值的研究

Value of cerebral microbleeds in predicting early recurrence of ischemic stroke

目的对脑微出血(CMB)与急性脑梗死90d内脑卒中复发风险进行研究,探讨CMB是否为脑梗死早期复发的预测因素。方法连续性筛选诊断为急性脑梗死患者234例,根据影像检查分为CMB组141例与无CMB组93例,随访90d,分别比较2组轻度、中度和重度CMB以及不同位置CMB患者脑卒中复发率,进行Kaplan-Meier生存曲线分析和Cox回归分析。结果 CMB组脑梗死复发率明显高于无CMB组(17.73%vs 6.45%,χ2=6.20,P=0.02)。重度CMB患者脑梗死复发率明显高于轻度和中度CMB患者(41.18%vs 11.27%vs 18.87%,χ2=8.49,P=0.01),位于脑叶、深部和混合位置CMB患者脑梗死复发率无明显差异(14.29%vs 17.33%vs 22.58%,P>0.05)。Kaplan-Meier生存分析显示,CMB组90d累积脑梗死复发率高于无CMB组(χ2=6.09,PLog-Rank=0.01),多元Cox回归分析显示,CMB是脑梗死复发的独立危险因素。结论 CMB可能为脑梗死早期复发的一项独立预测因素,且与CMB数目相关,与CMB位置无关。

Objective To study the value of cerebral microbleeds(CM B)in predicting early recurrence of ischemic stroke.Methods Two hundred and thirty-four acute ischemic stroke(A IS)patients who underwent SWI were divided into CMB group(n=1 4 1)and CMB-free group(n=9 3).The patients were followed up for 90 days,during which the number of CMB and recurrent rate of ischemic stroke were compared between the two groups,and analyzed by Kaplan-Meier survival curve analysis and Cox regression analysis respectively.Results The recurrent rate of ischemic stroke was significantly higher in CMB group than in CMB-free group(17.73%vs 6.%~6.20,P=0.02)and in severer CMB patients than in mild and moderate CMB patients(41.18%vs 11.27%vs 18.87%,%2=8.49,P=0.01).No significant difference was found in the recurrent rate of ischemic stroke between patients with their CMB located at different sites(14.29%vs 17.33%vs 22.58%,P>0.05).Kaplan-Meier survival curve analysis showed that the accumulated 90 d recurrent rate of ischemic stroke was higher in CMB group than in CMB-free group(x2=6.09,PLong-Rank=0.01).Multivariate Cox regression analysis revealed that CMB were an independent risk factor for the recurrence of ischemic stroke.Conclusion CMB are an independent predictive factor for the early recurrence of ischemic stroke,which is related with the number but not with the location of CMB.