缺血性脑卒中患者的左室射血分数与脑白质高信号的相关性

Correlation between left ventricular ejection fraction and cerebral white matter hyperintensity in patients with ischemic stroke

目的探讨老年缺血性脑卒中患者的左室射血分数(LVEF)与脑白质高信号(WMH)严重程度的相关性,从而预防性指导临床。方法回顾性选取2022年8月至2023年12月空军军医大学唐都医院康复医学科收治的241例老年缺血性脑卒中患者作为研究对象。根据fazekas评分将患者分为高级别脑白质高信号(HWMH)组(136例)和非HWMH组(105例),分析两组临床资料的差异。采用多因素logistic回归分析HWMH的影响因素,用受试者工作特征(ROC)曲线评估预测价值。结果与非HWMH组比较,HWMH组高血压比例以及尿酸、C反应蛋白(CRP)水平均明显升高,LVEF值明显降低,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,高血压、CRP、LVEF是HWMH的独立危险因素(P<0.05)。LVEF预测缺血性脑卒中患者HWMH的ROC曲线下面积为0.710(95%CI:0.645~0.774,P<0.001)。结论缺血性脑卒中患者的LVEF对WMH严重程度具有一定的预测价值,为WMH病理生理机制的研究提供了线索。

Objective To investigate the correlation between left ventricular ejection fraction(LVEF)and the severity of cerebral white matter hyperintensity(WMH)in elderly patients with ischemic stroke,thereby guiding its clinical prevention.Methods A total of 241 elderly patients with ischemic stroke admitted to the Department of Rehabilitation Medicine of Tangdu Hospital of Air Force Medical University from August 2022 to December 2023 were retrospectively selected as study subjects.The patients were divided into high-grade white matterhyperintensity(HWMH)group(n=136)and non-HWMH group(n=105)according to the fazekas score,and the differences in clinical data between the two groups were analyzed.Factors influencing HWMH were analyzed using multifactorial logistic regression.The predictive value was assessed by receiver operating characteristic(ROC)curve.Results The proportion of hypertension,uric acid,and C-reactive protein(CRP)levels were significantly higher and the LVEF value was significantly lower in the HWMH group compared with the non-HWMH group,with statistically significant differences(P<0.05).Multifactorial logistic regression analysis showed that hypertension,CRP,and LVEF were independent risk factors of HWMH(P<0.05).The area under the ROC curve of LVEF for predicting HWMH in patients with ischemic stroke was 0.710(95%CI:0.645-0.774,P<0.001).Conclusion LVEF in patients with ischemic stroke has a certain predictive value for the severity of WMH,which provides clues for further study on the pathophysiological mechanisms of WMH.