腔隙性脑梗死脑白质病变与脑微出血的相关性研究

Correlation between white matter lesions and cerebral microbleeds in lacunar infarction

目的探讨腔隙性脑梗死(LI)患者脑白质病变(WML)表现与脑微出血(CMBs)的关系。方法回顾性分析我院129例LI患者临床资料,根据CMBs病情程度将患者分为无出血组(n=20)、轻度组(n=60)、中度组(n=37)及重度组(n=12)。比较不同分组患者一般资料和实验室检测指标水平,分析CMBs与脑白质病变量表评分(WMLs)的相关性,采用Logistic多因素分析法分析LI患者WML和CMBs合并发病的相关因素。结果不同CMBs病情程度患者年龄和高血压合并症发生情况比较,差异有统计学意义(P<0.05)。不同CMBs病情程度患者血清HDL-C、LDL-C、hs-CRP、Hcy、CIMT及颈动脉斑块积分水平比较,差异均有统计学意义(P<0.05)。Logistic多因素回归分析显示,年龄、高血压、HDL-C、Hcy及CIMT是影响LI患者WML与CMBs合并发病的独立危险因素(P<0.05)。结论LI患者WML严重程度与CMBs病变程度呈正相关,年龄增长、高血压史、低水平HDL-C、高水平Hcy及CIMT增加是影响LI患者WML与CMBs合并发病的独立危险因素。

Objective To investigate the relationship between white matter lesions(WML)and cerebral microbleeds(CMBs)in patients with lacunar infarction(LI).Methods The clinical dataes from 129 patients with LI in our hospital were analyzed retrospectively.According to the severity of CMBs,the patients were divided into no bleeding group(n=20),mild group(n=60),moderate group(n=37)and severe group(n=12).The general data and laboratory results of patients in different groups were compared,the correlation between CMBs and white matter lesion scale(WMLs)was analyzed,the Logistic multivariate analysis was used to analyze the related factors of WML and CMBS in patients with LI.Results The age and the incidence of hypertension complication in patients with different CMBs were statistically significant(P<0.05).There were significant differences in serum HDL-C,LDL-C,hs-CRP,Hcy,CIMT levels and carotid plaque score in patients with different disease degrees of CMBs(P<0.05).Logistic regression analysis showed that age,hypertension,HDL-C,Hcy and CIMT were independent risk factors for the combined incidence of WML and CMBS in patients with LI(P<0.05).Conclusion The severity of WML in patients with LI is positively correlated with the degree of CMBs.The increase of age,history of hypertension,low-level HDL-C,high-level Hcy and CIMT are independent risk factors for the combined incidence of WML and CMBs in patients with LI.