脑血管病患者脑微出血的影响因素分析

Analysis of factors influencing cerebral microbleeds in patients with cerebrovascular disease

目的探讨脑血管病患者脑微出血(CMBs)的影响因素。方法回顾性分析80例脑血管病患者的临床资料,均行磁共振成像(MRI)检查,根据有无CMBs分为对照组(无CMBs,45例)和观察组(有CMBs,35例)。统计比较两组患者的临床资料,并进行脑血管病患者发生CMBs的多因素Logistic回归分析。结果两组性别、年龄及高血压、糖尿病、高血脂、冠心病、心房颤动、高同型半胱氨酸血症、肾功能不全、吸烟、抗血栓药物使用史占比比较差异均无统计学意义(P>0.05)。观察组患者临床诊断短暂性脑缺血发作(TIA)/脑梗死19例(54.29%)、脑出血12例(34.29%)、其他4例(11.43%),肥胖8例(22.86%),重度白质病变20例(57.14%),重度皮质下白质病变19例(54.29%),重度基底核白质病变13例(37.14%),幕下白质病变11例(31.43%);对照组患者临床诊断TIA/脑梗死34例(75.56%)、脑出血5例(11.11%)、其他6例(13.33%),肥胖3例(6.67%),重度白质病变10例(22.22%),重度皮质下白质病变10例(22.22%),重度基底核白质病变7例(15.56%),幕下白质病变5例(11.11%)。观察组临床诊断情况及肥胖、重度白质病变、重度皮质下白质病变、重度基底核白质病变、幕下白质病变占比与对照组比较差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,肥胖、脑出血、重度皮质下白质病变、重度基底核白质病变、幕下白质病变是脑血管病患者发生CMBs的独立危险因素(P<0.05)。结论脑血管病患者发生CMBs的影响因素较多,与肥胖、脑出血、重度白质病变等有关,重度基底核白质病变对CMBs的预测价值更高。

Objective To discuss the factors influencing cerebral microbleeds(CMBs)in patients with cerebrovascular disease.Methods The clinical data of 80 patients with cerebrovascular disease were retrospectively analyzed,all of whom underwent magnetic resonance imaging(MRI),and were divided into a control group(without CMBs,45 cases)and an observation group(with CMBs,35 cases)according to the presence or absence of CMBs.The clinical data of the two groups were statistically compared,and a multivariate Logistic regression analysis of the occurrence of CMBs in patients with cerebrovascular disease was performed.Results There were no statistically significant differences between the two groups in the comparison of gender,age,percentages of hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease,atrial fibrillation,hyperhomocysteinemia,renal insufficiency,history of smoking and antithrombotic drug use(P>0.05).The observation group had 19 cases(54.29%)of transient ischemic attack/cerebral infarction,12 cases(34.29%)of cerebral hemorrhage,4 cases(11.43%)of others,8 cases(22.86%)of obesity,20 cases(57.14%)of severe white matter lesions,19 cases(54.29%)of severe subcortical white matter lesions,13 cases(37.14%)of severe basal nucleus white matter lesions,and 11 cases(31.43%)of subcurtain white matter lesions.The control group had 34 cases(75.56%)of TIA/cerebral infarction,5 cases(11.11%)of cerebral hemorrhage,6 cases(13.33%)of others,3 cases(6.67%)of obesity,10 cases(22.22%)of severe white matter lesions,10 cases(22.22%)of severe subcortical white matter lesions,7 cases(15.56%)of severe basal nucleus white matter lesions,and 5 cases(11.11%)of subcurtain white matter lesions.The clinical diagnosis and proportions of obesity,severe white matter lesions,severe subcortical white matter lesions,severe basal nucleus white matter lesions,and subtentorial white matter lesions in the observation group were statistically significant compared with those in the control group(P<0.05).Multivariate Logistic regression analysis showed that obesity,cerebral hemorrhage,severe subcortical white matter lesions,severe basal ganglia white matter lesions,and subtential white matter lesions were independent risk factors for CMBs in cerebrovascular patients(P<0.05).Conclusion There are many factors influencing the occurrence of CMBs in cerebrovascular disease patients,which are related to obesity,cerebral hemorrhage,and severe white matter lesions,and severe basal nucleus white matter lesions have higher predictive value for CMBs.