中重度脑白质疏松与急性腔隙性脑梗死患者CMBs进展的相关性

Correlation between Moderate and Severe Leukoaraiosis and CMBs Progression in Patients with Acute Lacunar Infarction

目的:观察急性腔隙性脑梗死(LI)患者脑白质疏松(LA)程度及脑微出血(CMBs)进展情况,分析中重度LA与CMBs进展的相关性。方法:回顾性分析2018年1月-2019年6月本院收治的106例急性LI患者的资料,患者入院2 d内及随访12个月后均接受头颅磁共振(MRI)检查,根据头颅MRI影像学表现评定患者LA及CMBs进展。比较不同程度CMBs患者LA程度,分析CMBs进展与LA程度的关系。结果:106例急性LI患者,后期随访12个月发生进展性CMBs 41例,未发生进展性CMBs 65例。CMBs 1级23例,2级11例,3级7例。不同程度CMBs患者LA程度比较,差异有统计学意义(P<0.001)。0级组LA程度优于1、2、3级组,1级组优于2、3级组,差异均有统计学意义(P<0.05)。Spearman相关分析显示,中重度LA与急性LI患者CMBs程度呈正相关(P<0.001)。结论:急性LI患者CMBs进展发生率较高,CMBs级别越高患者LA程度越严重,中重度LA可能是急性LI患者脑出血进展的影响因子,可为早期预防治疗提供有效依据。

Objective:To observe the LA degree and the progression of cerebral microhemorrhage (CMBs) in patients with acute lacunar infarction (LI),and analyze the correlation between moderate and severe LA and the progression of CMBS.Method:The data of 106 patients with acute LI admitted to our hospital from January 2018 to June 2019 were retrospectively analyzed.All patients received head magnetic resonance imaging (MRI) examination within 2 days after admission and 12 months after follow-up.LA degree and CMBs progression were assessed according to head MRI imaging findings.The LA degree of patients with different degrees of CMBs was compared,and the relationship between the progression of CMBs and the LA degree was analyzed.Result:Among 106 patients with acute LI,41 patients developed progressive CMBs and 65 patients did not.There were 23 cases of CMBs grade 1,11 cases of CMBS grade 2 and 7 cases of CMBs grade 3.LA degree in patients with different degrees of CMBs compared,the difference was statistically significant (P<0.001).The degree of LA in grade 0 group was better than those in grade 1,2 and 3 groups,and that in grade 1 group was better than that in grade 2 and 3 groups,the differences were statistically significant (P<0.05).Spearman correlation analysis showed that moderate to severe LA was positively correlated with the degree of CMBs in patients with acute LI (P<0.001).Conclusion:The incidence of CMBs progression is higher in patients with acute LI.The higher the CMBs level is,the more serious the degree of LA is.Moderate and severe LA may be the influencing factor of cerebral hemorrhage progression in patients with acute LI,which can provide effective basis for early prevention and treatment.