大动脉粥样硬化型脑梗死患者脑微出血与脑动脉狭窄的相关性

The relationship between cerebral microbleeds and cerebral artery stenosis in patients with large atherosclerotic cerebral infarction

目的探讨大动脉粥样硬化型(large artery atherosclerosis,LAA)脑梗死患者脑微出血(cerebral microbleeds,CMBs)与颅内外动脉狭窄的相关性。方法纳入2018年10月-2021年6月期间于我院神经内科住院,首次发生LAA型脑梗死患者512例。根据头部磁敏感加权成像(susceptibility weighted imaging,SWI)结果将患者分为有、无CMBs组,统计分析LAA型脑梗死急性期CMBs的检出率、危险因素及其与脑动脉狭窄的相关性。结果CMBs总检出率为39.3%;年龄、高血压、高同型半胱氨酸血症、抗血小板药物应用史、WMH、颅内动脉或颅内外动脉狭窄共存与CMBs独立相关;CMBs严重程度与脑动脉狭窄程度呈正相关。结论年龄、高血压、高同型半胱氨酸血症、抗血小板药物应用史、WMH、单纯颅内动脉或颅内、外动脉狭窄共存为CMBs独立危险因素;CMBs严重程度与脑动脉狭窄程度呈正相关;三酰甘油可能是CMBs的保护性因素。

Objective To investigate the relationship between cerebral microbleeds and cerebral artery stenosis in patients with large atherosclerotic cerebral infarction.Methods We retrospectively enrolled 512 patients with large atherosclerotic cerebral infarction who were the first time admitted to the Department of Neurology of our hospital from October 2018 to June 2021.According to the results from the craniocerebral magnetic sensitive weighted imaging,patients were divided into non-CMBs group and CMBs group.The purpose of this study was to investigate the risk factors and incidence rate of CMBs,the relationship between cerebral microbleeds and cerebral artery stenosis in patients with large atherosclerotic cerebral infarction.Results The incidence rate of CMBs was 39.3%in this study.Factors including age,hypertension,hyperhomocysteinemia,history of antiplatelet drug use,WMH,intracranial and extracranial artery stenosis coexisted independently with CMBs.The degree of CMBs is positively correlated with cerebral artery stenosis.Conclusion Age,hypertension,high-profile cysteinemia,anti-platelet drug application history,WMH and intracranial artery or both of extracranial vessels stenosis are independent risk factors of CMBs.The degree of CMBs is positively correlated with cerebral artery stenosis.Triacylglycerol may be a protective factor for CMBs.