摘要
目的探讨影响≥80岁患者脑白质疏松症(LA)严重程度的危险因素,分析糖尿病患者LA严重程度的特点。方法选择2016年12月至2018年1月于安徽医科大学第三附属医院就诊的年龄≥80岁,经头颅磁共振成像证实存在LA的202例患者为研究对象。根据年龄相关性脑白质病变(ARWMC)评分对LA严重程度进行评估,比较不同等级LA患者的临床资料。根据入院时糖化血红蛋白(HbA1c)水平将糖尿病患者分为3组,比较3组患者的临床特征。采用SPSS 22.0统计软件对数据进行分析。根据数据类型分别采用单因素方差分析、χ^(2)检验和秩和检验。LA相关危险因素采用logistic回归分析。结果随着LA严重程度的增加,年龄呈升高趋势,糖尿病患病率上升,空腹血糖水平升高,组间比较,差异有统计学意义(P<0.05)。糖尿病组ARWMC评分[6.00(4.00,8.00)]明显高于非糖尿病组[4.00(3.00,6.00)],差异有统计学意义(P<0.001)。糖尿病组多元logistic回归分析显示,年龄、HbA1c水平升高是LA严重程度的独立危险因素。结论高龄LA患者中,年龄、糖尿病与LA病变严重程度相关;合并糖尿病的高龄LA患者,HbA1c水平与LA严重程度独立相关。
Objective To investigate the risk factors for the severity of leukoaraiosis(LA)in patients aged≥80 years and analyze the characteristics of LA in the diabetic patients.Methods Totally 202 patients aged≥80 years who were identified with LA by head MRI in the Third Affiliated Hospital of Anhui Medical University were recruited in this study.The severity of LA was assessed according to the rating scale for age-related white matter changes(ARWMC).The clinical baseline data were compared among the patients with different severities of LA.According to glycosylated hemoglobin A1c(HbA1c)at admission,the diabetic patients were further divided into 3 subgroups,and their clinical features were compared.SPSS statistics 22.0 was used to perform the statistical analysis.One-way ANONA,Chi-square test and rank sum test was employed for different data types.Related risk factors for LA were analyzed with logistic regression analysis.Results As the severity of LA increased,the age showed an increasing trend,the prevalence of diabetes was elevated,and the fasting blood glucose level was increased,statistical differences were seen among the three groups(P<0.05).The ARWMC score was obviously higher in the diabetic group than the non-diabetic group[6.00(4.00,8.00)vs 4.00(3.00,6.00),P<0.001].Multinomial regression analysis found that age and HbA1c level were independent risk factors for LA severity in diabetic mellitus group.Conclusion In the very old patients with LA,age and diabetes are correlated with LA severity.In the elderly diabetic patients with LA,HbA1c level is independently correlated with LA severity.
作者
王萍
刘玉
王书
唐敏
周群
WANG Ping;LIU Yu;WANG Shu;TANG Min;ZHOU Qun(Department of Geriatrics,Third Affiliated Hospital of Anhui Medical University,Hefei 230013,China;Department of Neurology,Third Affiliated Hospital of Anhui Medical University,Hefei 230013,China;Department of Neurology,Hefei BOE Hospital,Hefei 230061,China)
出处
《中华老年多器官疾病杂志》
2021年第7期527-531,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
