影响基底节区和半卵圆中心血管周围间隙扩大的相关因素分析

Analysis of the factors influencing expansion of Virchow-Robin spaces in basal ganglia and central semiovale

目的分析影响基底节区、半卵圆中心血管周围间隙(VRS)扩大的相关因素。方法回顾性分析辽宁省健康产业集团抚矿总医院(中国医科大学第七临床学院)2015年6月至2019年6月收治急性单发腔隙性脑梗死196例患者资料,其中基底节区脑梗死108例,半卵圆中心脑梗死88例,以MRI评价患者VRS扩大程度,并对影响基底节区和半卵圆中心VRS扩大的相关因素进行单因素分析、多因素Logistic回归分析。结果单因素分析结果提示,基底节区VRS的轻度扩大组(48例)与重度扩大组(148例)比较,女性(22例比40例)、高血压比例[35.4%(17/48)比78.4%(116/148)]、收缩压[(138.7±14.2)mmHg(1 mmHg=0.133 kPa)比(150.3±12.0)mmHg]及体质量指数(BMI)[(26.7±2.5)kg/m2比(24.1±2.2)kg/m2]等比较差异有统计学意义(P<0.05或<0.01);半卵圆中心VRS的轻度扩大组(79例)与重度扩大组(117例)比较,高血压及糖尿病比例、BMI等比较差异有统计学意义(P<0.05)。多因素回归分析结果提示,高血压(OR=6.383,95%CI 1.942~18.204,P=0.005)、BMI(OR=0.768,95%CI 0.620~0.938,P=0.010)明显影响基底节区VRS扩大的程度,而BMI明显影响半卵圆中心VRS扩大的程度(OR=0.784,95%CI 0.642~0.921,P=0.003)。结论急性腔隙性脑梗死患者中高血压是危险因素影响基底节区VRS的扩大程度,而BMI是基底节区与半卵圆中心VRS扩大的保护性因素。

Objective To investigate the factors influencing expansion of Virchow-Robin spaces(VRS)in basal ganglia and central semiovale.Methods One hundred and ninety-six patients with acute single lacunar infarction were analyzed retrospectively from June 2015 to June 2019 in Fukuang General Hospital of Liaoning Health Industry Group(Seventh Clinical College of China Medical University).Among them,108 patients with basal ganglia infarction and 88 patients with central semiovale infarction were included.MRI was used to evaluate the extent of VRS expansion.Univariate analysis and multivariable Logistic regression analysis were used to analyze the related factors affecting VRS expansion in basal ganglia and central semiovale.Results Univariate analysis showed that there were significant differences in the female,proportion of hypertension,systolic blood pressure and body mass index(BMI)between the mild enlarged group(48 cases)and the severe enlarged group(148 cases)of VRS expansion in basal ganglia:22 cases vs.40 cases,35.4%(17/48)vs.78.4%(116/148),(138.7±14.2)mmHg(1 mmHg=0.133 kPa)vs.(150.3±12.0)mmHg and(26.7±2.5)kg/m2 vs.(24.1±2.2)kg/m2,and there were statistical differences(P<0.05 or<0.01);and there were significant differences in the proportion of hypertension,diabetes mellitus and BMI between the mild enlarged group(79 cases)and the severe enlarged group(117 cases)of VRS expansion in central semiovale(P<0.05).Multivariable Logistic regression analysis showed that hypertension(OR=6.383,95%CI 1.942 to 18.204,P=0.005),BMI(OR=0.768,95%CI 0.620 to 0.938,P=0.010)significantly affected the expansion of VRS expansion in basal ganglia,while BMI significantly affected the expansion of VRS expansion in central semiovale(OR=0.784,95%CI 0.642 to 0.921,P=0.003).Conclusions Hypertension is the independent risk factor of VRS expansion in basal ganglia,and BMI is the protective factor of VRS expansion in basal ganglia and central semiovale.