101例脑小血管病患者脑微出血危险因素的回顾性分析

A retrospective analysis of risk factors of cerebral microbleeds in 101 patients with cerebral small vessel disease

目的探讨脑小血管病(CSVD)患者脑微出血(CMBs)的独立危险因素。方法回顾性收集符合脑小血管病影像学诊断的患者101例,按是否存在CMBs分为CMBs组和非CMBs组,统计学分析识别CMBs的危险因素和保护因素。结果与CSVD中非CMBs组患者比较,CMBs组患者中高血压所占比例较高(χ~2=9.879,P=0.002),超敏C反应蛋白(hs-CRP)(t=2.294,P=0.024)、同型半胱氨酸(Hcy)(t=2.193,P=0.031)、半胱氨酸蛋白酶抑制剂C(Cys-C)(t=2.160,P=0.034)、脂蛋白a(Lpa)(t=4.247,P<0.001)水平较高,低密度脂蛋白胆固醇(LDL-c)(t=-3.342,P=0.001)水平较低。Logistic回归分析结果显示,高血压(P=0.002,OR=6.706,95%CI:2.011~22.362)、hs-CRP(P=0.049,OR=1.279,95%CI:1.001~1.635)、Lpa(P=0.001,OR=1.006,95%CI:1.003~1.009)和LDL-c(P=0.039,OR=0.472,95%CI:0.232~0.963)与CMBs独立相关。结论高血压、hs-CRP、Lpa是CMBs的独立危险因素,LDL-c是CMBs的保护因素。

Objective To investigate the independent risk factors of cerebral microbleeds(CMBs)in patients with cerebral small vessel disease(CSVD).Methods A total of 101 patients who met the imaging diagnostic criteria of CSVD were divided into CMBs group and non-CMBs group.The risk factors and protective factors of CMBs were identified with statistical analysis.Results Compared with non-CMBs group,CMBs group had a higher incidence of hypertension(χ~2=9.879,P=0.002),higher levels of high-sensitivity C-reactive protein(hs-CRP)(t=2.294,P=0.024),homocysteine(Hcy)(t=2.193,P=0.031),cystatin C(Cys-C)(t=2.160,P=0.034)and lipoprotein a(Lpa)(t=4.247,P<0.001),but lower level of low-density lipoprotein cholesterol(LDL-c)(t=-3.342,P=0.001).Logistic regression analysis showed that hypertension(P=0.002,OR=6.706,95%CI:2.011-22.362),hs-CRP(P=0.049,OR=1.279,95%CI:1.001-1.635),Lpa(P=0.001,OR=1.006,95%CI:1.003-1.009)and LDL-c(P=0.039,OR=0.472,95%CI:0.232-0.963)were independently correlated with CMBs.Conclusion Hypertension,hs-CRP and Lpa are the independent risk factors of CMBs,whereas LDL-c is a protective factor.