急性脑梗死患者中扩大的血管周围间隙的影响因素及预后研究

Study on influencing factors and prognosis of enlarged perivascular space in patients with acute cerebral infarction

目的探讨不同脑区扩大的血管周围间隙的影响因素及其与预后的相关性研究.方法选取2018年1月—2018年12月汕头大学医学院附属粤北人民医院神经内科住院的急性脑梗死患者120例.根据血管周围间隙扩大(EPVSs)评分分为轻度组(0~1级)和重度组(2~4级);根据不同脑区分为脑白质区(轻度组69例,重度组51例)、基底节区(轻度组66例,重度组54例).随访6个月后,根据Rankin生活能力量表(mRS)评分分为预后良好组(79例)和预后不良组(41例).采用单因素及多因素Logistic回归分析比较不同脑区病变程度的EPVSs的及预后不良组的相关影响因素.结果年龄≥65岁、高血压史、入院NIHSS评分>3分是脑白质区严重组EPVSs的独立危险因素(P<0.05).男性、高血压史、脑白质疏松史是基底节区严重组EPVSs的独立危险因素(P<0.05).基底节区重度EPVSs与预后不良明显相关性(P<0.05).高血压史、入院NIHSS评分>3分是预后不良结局的独立危险因素(P<0.05).结论不同脑区、不同严重程度EPVSs存在不同的影响因素,高血压史、入院NI-HSS评分>3分的EPVSs患者,多提示预后不良,对临床上特异性治疗具有重要的指导意义.

Objective To investigate the influence factors of enlarged perivascular space(EPVSs)in different brain regions and its correlation with prognosis.Methods 120 cases of acute cerebral infarction hospitalized in the department of neurology of our hospital from January 2018 to December 2018 were selected,according to the EPVSs score,they were divided into mild group(grade 0~1)and severe group(grade 2~4),according to the different brain areas in the perivascular space,they were divided into white matter areas(69 cases in the mild group and 51 cases in the severe group)and basal ganglia areas(66 cases in the mild group and 54 cases in the severe group),according to the Rankin ability to live scale(mRS score),there were 79 patients in the good prognosis group and 41 patients in the poor prognosis group;Univariate and Multivariate Logistic regression analysis was used to compare the correlation factors of EPVSs between different brain region and poor prognosis group.Results Age ≥65,history of hypertension,NIHSS score on admission >3 points was an independent risk factor for severe EPVSs in the white matter region(P<0.05);Men,history of hypertension,and history of white matter osteoporosiswere independent risk factors for EPVSs in the severe basal ganglia group(P<0.05);Severe EPVSs in basal ganglia area was significantly correlated with poor prognosis(P<0.05);History of hypertension,admission NIHSS score >3 were an independent risk factor for poor prognosis(P<0.05).Conclusion There are different influencing factors for the EPVSs in different brain regions with different severity.EPVSs patients with a history of hypertension and an admission NIHSS score of > and 3 were more likely to have a poor prognosis,which has important guiding significance for clinical specific treatment.