急性单发腔隙性脑梗死患者BG/CSO-VRS扩大严重程度的危险因素分析

Risk factor analysis of severity of BG/CSO-VRS enlargement in patients with acute single lacunar infarction

目的探讨急性单发腔隙性脑梗死患者基底节(basal ganglia,BG)/半卵圆中心(central semioval,CSO)-血管周围间隙(Virchow-Robin Spaces,VRS)扩大严重程度的危险因素。方法回顾性分析本院2018年1月-2019年3月收治急性单发腔隙性脑梗死患者共476例的临床资料,其中基底节(BG)梗死262例,半卵圆中心(CSO)梗死214例,根据影像学手段评估BG/CSO-VRS扩大严重程度;采用χ~2检验和Logistic回归模型分析确定BG/CSO-VRS扩大严重程度的相关危险因素。结果基底节和半卵圆中心梗死VRS评分比较无显著差异(P>0.05);BG-VRS轻度扩大和重度扩大患者性别、高血压病比例、收缩压及BMI水平比较有明显差异(P<0.05);CSO-VRS轻度和重度扩大患者高血压病、糖尿病比例及BMI水平比较有明显差异(P<0.05);采用多因素Logistic回归模型分析显示,高血压病和BMI均是BG-VRS扩大严重程度的独立影响因素(P<0.05),而BMI也是CSO-VRS扩大严重程度的独立影响因素(P<0.05)。结论高血压病和BMI与急性单发腔隙性脑梗死患者VRS扩大密切相关,其中合并高血压病和BMI降低是导致BG-VRS扩大的独立危险因素,而BMI降低也是CSO-VRS扩大的独立危险因素。

Objective To investigate the risk factors of severity of BG/CSO-VRS enlargement in patients with acute single lacunar infarction.Methods Clinical data of 476 patients with acute single lacunar infarction were retrospectively chosen from January 2018 to March 2019 and all patients includeed 262 cases with cerebral infarction in basal ganglia and 214 cases with cerebral infarction in semioval center, the severity of BG/CSO-VRS enlargement were assessed by imaging methods, and the risk factors related to severity of BG/CSO-VRS enlargement were determined by χ~2 test and logistic regression mode.Results There was no significant differences in the VRS score of cerebral infarction between basal ganglia and semioval center(P>0.05). There were significant differences in the gender, hypertension proportion, systolic blood pressure and BMI between patients with mild and severe enlargement of BG-VRS(P<0.05). There were significant differences in the hypertension proportion, diabetes mellitus and BMI levels between patients with CSO-VRS mild and severe enlargement of BG-VRS(P<0.05). Multivariate analysis by logistic regression model showed that hypertension and BMI were the independent influencing factors of severity of BG-VRS enlargement(P<0.05)and BMI was also the independent influencing factor on severity of CSO-VRS enlargement(P<0.05).Conclusion Hypertension and BMI were closely related to VRS enlargement of patients with acute single lacunar infarction, and hypertension and BMI elevation were independent risk factors of BG-VRS enlargement, while BMI elevation was also the independent risk factor of CSO-VRS enlargement.