脑小血管病的影像总负荷评估及相关危险因素的研究

Total imaging load evaluation and related risk factors in cerebral small vessel disease

目的评估脑小血管病(cerebral smallvesseldisease,CSVD)的影像总负荷(总CSVD评分)及其相关危险因素。方法回顾性分析2019年5月至2020年5月于镇江市第四人民医院及其辖区神经内科就诊的CSVD患者的临床资料,根据全脑MRI影像特征分为发生脑卒中风险的低负荷组(LRL组,总CSVD评分≤2分)和高负荷组(HRL组,总CSVD评分>2分)。记录两组性别、年龄、吸烟史、高血压病史、空腹血糖、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(T-CHO)、甘油三酯(TG)、小而低密度脂蛋白胆固醇(sdLDL-C)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、抑光素C(CysC)及C-反应蛋白(CRP)等资料并进行单因素分析。采用多因素Logistic回归分析CSVD患者脑卒中总负荷的独立危险因素。结果研究共纳入97例CSVD患者,其中HRL组58例,LRL组39例。两组年龄、高血压病史、空腹血糖、HbA1c、TG、sdLDL-C及NGAL比较差异有统计学意义(P<0.05)。Logistic回归分析显示年龄、HbA1c、sdLDL-C及NGAL为CSVD患者脑卒中高风险负荷的独立危险因素(P<0.05)。结论年龄、HbA1c、sdLDL-C及NGAL可能是CSVD患者脑卒中总负荷的独立危险因素。

Objective To evaluate the total imaging load in cerebral small vessel disease(CSVD)based on total CSVD score and investigate the related risk factors.Methods The clinical dates of with CSVD from Neurology Departments of the Fourth People's Hospital of Zhenjiang and the community under its jurisdiction from May 2019 to May 2020 were retrospective analysis.According to the characteristics of whole brain MRI,all patients were divided into low risk of Loading group(LRL group,with stroke risk based on total CSVD score≤2 scores)and high risk of Loading group(HRL group,based on total CSVD score>2 scores).Baseline data including gender,age,smoking,hypertension,fasting blood glucose,glycat-ed hemoglobin(HbA1c),low density lipoprotein cholesterol(LDL-C),total cholesterol(T-CHO),triglyceride(TG),small and low-density lipoprotein cholesterol(sdLDL-C),neutrophil gelatinase-related lipocalin(NGAL),photostatin C(CysC)and C-reactive protein(CRP)of the two groups were collected to perform the univariate analysis.Multivariate Logistic regression analysis was used to identify the independent risk factors of total stroke load in patients with CSVD.Results A total of 97 CSVD patients were identified,including 58 casesin in HRL group and 39 cases in LRL group.Univariate analysis showed that age,hypertension,fasting blood glucose,HbA1c,TG,sdLDL-C and NGAL were correlated with total stroke load.Multivariate Logistic regression analysis showed that age,HbA1c,sdLDL-C and NGAL were independent risk factors of total stroke load in CSVD(P<0.05).Conclusion Advanced age,increased HbA1c,high level of sdLDL-C and NGAL were independent risk factors for high stroke load in pa-tients with CSVD.