腔隙性脑梗死病人血管周围间隙扩大的影响因素探讨

Influencing factors of perivascular space expansion in patients with lacunar infarction

目的探讨急性腔隙性脑梗死病人血管周围间隙扩大程度的影响因素。方法选择2017年9月至2019年3月滁州市第一人民医院神经内科收治的基底节区梗死病人80例与半卵圆中心梗死病人82例,回顾性分析两组病人的临床资料。通过MRI对病人血管周围间隙扩大程度进行评价,经单因素分析以及多因素logistic回归分析基底节区血管周围间隙与半卵圆中心血管间隙扩大程度的影响因素。结果本研究共162例病人,其中基底节区血管周围间隙轻度扩大有41例,重度扩大有121例;半卵圆中心血管周围间隙轻度扩大有62例,重度扩大有100例。基底节区血管间隙轻度扩大组女性比例以及平均体质量指数大于重度扩大组[46.34%比18.18%,(26.34±2.15)比(24.05±3.21)],轻度扩大组病人的平均收缩压以及高血压人数比例小于重度扩大组[(138.63±12.21)mmHg比(149.95±15.06)mmHg,36.59%比80.99%](P<0.05)。半卵圆中心血管间隙轻度扩大组高血压、糖尿病病人比例均小于重度扩大组(56.45%比75.00%,12.90%比27.00%),轻度扩大组病人体质量指数(26.41±2.52)kg/m2大于重度扩大组(23.86±2.93)kg/m2,P<0.05。通过多因素logistic回归分析,体质量指数与高血压对病人基底节区血管周围间隙扩大具有明显影响,体质量指数对半卵圆中心血管间隙扩大具有明显影响。结论针对急性腔隙性脑梗死病人,高血压是导致病人基底节区血管周围间隙扩大的危险因素,体质量指数是基底节区与半卵圆中心血管周围间隙扩大程度的保护因素。

Objective To investigate the influencing factors of the degree of perivascular space expansion in patients with acute lacunar infarction.Methods Eighty-eight patients with infarction in the basal ganglia and 82 patients with semi-oval center infarction in the Department of Neurology,First People's Hospital of Chuzhou City from September 2017 to March 2019 were enrolled.The clinical data of the two groups were retrospectively analyzed.MRI was used to evaluate the degree of perivascular space enlargement.The factors affecting the degree of cardiovascular space expansion in the perivascular space of the basal ganglia and the semi-oval were analyzed by univariate analysis and multivariate logistic regression.Results A total of 162 patients were included in the study.There were 41 cases with a slight enlargement of the perivascular space in the basal ganglia and 121 cases with severe enlargement.There were 62 cases of mild enlargement of the perivascular space in the semi-oval,and 100 cases of severe enlargement.The proportion of women(46.34%vs.18.18%)and the body mass index[(26.34±2.15)vs.(24.05±3.21)]in slightly enlarged vascular stenosis in the basal ganglia group were higher than those in the severely enlarged group(P<0.05).The average systolic blood pressure[(138.63±12.21)mmHg vs.(149.95±15.06)mmHg]and the proportion of patients with hypertension(36.59%vs.80.99%)in the slightly enlarged group were less than those in the severely enlarged group(P<0.05).The proportion of patients with hypertension(56.45%vs.75.00%)or diabetes(12.90%vs.27.00%)in slightly enlarged vascular stenosis in the basal ganglia of the semi-oval group were less than those in the severely enlarged group,and the body mass index[(26.41±2.52)kg/m^(2) vs.(23.86±2.93)kg/m^(2)]of the slightly enlarged group was higher than that of the severely enlarged group(P<0.05).Through multivariate logistic regression analysis,body mass index and hypertension had significant effects on the expansion of perivascular space in the basal ganglia of patients,and the body mass index had a significant effect on the expansion of cardiovascular space in the semi-oval.Conclusion For patients with acute lacunar infarction,hypertension is a risk factor for the expansion of perivascular space in the basal ganglia,and the body mass index is a protective factor for the degree of enlargement of the perivascular space in the basal ganglia and semi-oval.