中老年无症状脑梗死患者静态平衡功能特征及影响因素分析

Analysis of balance function characteristics and influencing factors in middle-aged and elder patients with silent brain infarction

目的:探讨中老年无症状脑梗死(SBI)患者的静态平衡功能特征变化及相关影响因素。方法:基于医院体检信息系统回顾性收集2019年3月—2020年6月于福建省第二人民医院体检中心行平衡功能检测的139例SBI患者及330例同期正常对照者的体检资料,按年龄对两组进行1∶1评分倾向性评分匹配。在匹配后比较两组静态平衡功能特征之间的差异,并采用多元线性回归分析其平衡功能的影响因素。结果:共匹配73对,其中≥60岁者46对,<60岁者27对。SBI患者在单足睁眼轨迹图面积(SSKG)及动摇总轨迹长(LNG)、单足闭眼LNG及双足睁眼SSKG均显著高于正常对照组(P<0.05),其差异主要表现在≥60岁组SBI患者。≥60岁组SBI患者在单足闭眼SSKG、LNG及双足睁眼SSKG均明显高于<60岁组SBI患者(P<0.05)。多元线性回归结果显示脑萎缩及脑梗死部位与单足闭眼LNG存在显著的线性关系(P<0.05);基底节区合并其他部位的梗死灶与单足睁眼LNG存在显著的线性关系(P=0.022),当SBI患者基底节区合并其他脑区损伤时,其单足睁眼下平衡功能较非基底节区损害者更弱;病灶大小与因变量之间均无显著线性关系(P>0.05)。结论:SBI患者的静态平衡功能较正常人下降,且受到年龄、脑萎缩及脑梗死部位的影响。

Objective:To observe the changes of balance function characteristics in middle-aged and elder patients with silent brain infarction(SBI) and its related influencing factors.Method:Based on information checking systems of health check center, second people’s hospital of Fujian province,we retrospectively selected 139 patients with SBI and 330 normal controls who participated in health examination from March 2019 to June 2020 according to certain standard, and then these participants were matched by propensity score matching according to ages in a ratio of 1∶1. After comparing the differences of balance function characteristics between groups, the influencing factors of balance dysfunction were analyzed by multiple linear regression.Result:73 pairs of cases were successfully matched,containing 46 pairs of elderly(≥60 years old) and 27 pairs of middle-aged cases(<60 years old). The value of statokinesigram area(SSKG) in single leg standing with eye opening and both feet standing with eye opening,the track length(LNG) in single leg standing with eye opening and eye closed of SBI patients were significantly higher than those of normal control group(P<0.05). Besides,the main differences were found in elder SBI patients. In addition,SSKG and LNG in single leg standing with eye closed and SSKG in both feet standing with eye opening of elder SBI patients were significantly higher than those of middle-aged SBI group(P<0.05). Multiple linear regression showed that there was a significant linear relationship between the sides of cerebral infarction and brain atrophy with LNG in single leg standing with eye closed(P<0.05). The infarcted areas were also significantly linear related with LNG in single leg standing with eye opening(P=0.022),which means the damages in basal ganglia combining with other cerebral areas showed worse balance function than patients with infarction in other brain regions or in basal ganglia only. And there was no significant linear relationship between the balance function and any dependent variables(P>0.05).Conclusion:The static balance functions of SBI patients were worse than those of normal people and were affected by age,sites of cerebral infarction and brain atrophy.