摘要
目的:分析急性脑梗死患者脑微出血(CMBs)的危险因素。方法:回顾性分析急性脑梗死患者336例临床资料,根据磁敏感加权成像(SWI)扫描是否存在CMBs分为无CMBs组154例,CMBs组182例;CMBs组按CMBs分布的位置分为大脑皮质、皮质下、基底节及幕下。比较2组患者人口学特征、相关危险因素、血液检验结果及美国国立卫生研究院卒中量表(NIHSS)评分,并进行相关性分析;比较CMBs组中不同出血部位患者的尿酸、同型半胱氨酸(Hcy)和NIHSS评分。结果:与无CMBs组相比,CMBs组的尿酸和Hcy水平更高,合并高血压病、糖尿病、高总胆固醇及既往脑卒中病史的几率均更高(P<0.05);Logistic回归分析结果显示,高血压、高血糖、高胆固醇血症、脑卒中病史、Hcy和尿酸水平与CMBs的发生有关(P<0.05);高尿酸、高Hcy、糖尿病、脑卒中病史、高胆固醇血症和高血压均为CMBs发生的独立预测因素;不同部位CMBs的发生率差异无统计学意义(P>0.05);CMBs分布于不同部位患者的尿酸水平、Hcy水平及NIHSS评分差异无统计学意义(P>0.05)。结论:高尿酸、高Hcy、糖尿病、脑卒中病史、高胆固醇血症和高血压可能是急性脑梗死患者发生CMBs的独立危险因素。CMBs分布的部位对NIHSS评分无影响。
Objective: To analysis the risk factors of cerebral microbleeds(CMBs) in patients with acute cerebral infarction. Methods: Clinical data of 336 patients with acute cerebral infarction was retrospectively analyzed. All the cases were divided into non-CMBs group (n=154) and CMBs group (n=182) according to SWI scan. Cases in the CMBs group were further divided into four sub-groups according to CMBs location. Demographic characteristics, risk factors, blood test results, and National Institutes of Health Stroke Scale (NIHSS) scores of two groups were compared and analyzed. The levels of uric acid and homocysteine and the NIHSS scores of four sub-groups were compared and analyzed. Results: Compared with those in the non-CMBs group, cases in CMBs group had higher levels of uric acid and homocysteine, higher incidence rate of hypertension, diabetes, hyperlipidemia and stroke history (P<0.05). Logistic regression analysis showed that hypertension, hyperglycemia, hypercholesterolemia, stroke history, homocysteine and uric acid levels were associated with CMBs (P<0.05). High levels of uric acid and homocysteine, hyperglycemia, history of stroke, hypercholesterolemia and hypertension are independent predictors of CMBs (P<0.05). No significant difference was detected in the incidence rates of CMBs in four sub-groups (P>0.05). No significant differences were detected in levels of uric acid and homocysteine, NIHSS scores in four sub-groups (P>0.05). Conclusion: High levels of homocysteine and uric acid, hypertension, hyperglycemia, hypercholesterolemia and stroke history maybe risk factors of CMBs in patients with acute cerebral infarction. The location of CMBs distribution has no effect on the NIHSS score.
作者
湛彦强
许峰
邢变枝
张海栋
段申汉
曾非
姚涛
ZHAN Yan-qiang;XU Feng;XING Bian-zhi;ZHANG Hai-dong;DUAN Shen-han;ZENG Fei;YAO Tao(Department of Neurology, Renmin Hospital of Wuhan University, Wuhan 430063, China;Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China)
出处
《神经损伤与功能重建》
2019年第2期65-67,71,共4页
Neural Injury and Functional Reconstruction
基金
湖北省自然科学基金项目(No.2016CF B575
No.2016CFB552)
武汉大学人民医院引导基金(No.RM YD2018M09)
华中科技大学自主创新研究基金重点专项项目(No.2015ZHYX010)
