摘要
目的探讨血浆β2微球蛋白(β2M)水平与老年腔隙性脑梗死患者脑小血管病(CSVD)核磁共振成像(MRI)总负荷的关系。方法回顾性选择常州市第二人民医院神经内科2018年8月至2019年8月收治的老年腔隙性脑梗死患者93例, 所有患者均完成头颅磁共振检查及血浆β2M测定。入组患者依据CSVD总负荷评分0到4分, 共分为5组。比较组间临床资料差异分析血清β2M与CSVD总负荷的关系。结果老年腔隙性脑梗死患者中CSVD总负荷0分(20.43%)19例, 1分(20.43%)19例, 2分(24.73%)23例, 3分(22.58%)21例, 4分(11.83%)11例, 5组间患者年龄、糖尿病、收缩压、舒张压、糖化血红蛋白、血浆β2M、eGFR比较差异有统计学意义(P<0.05), 进一步Spearman相关性分析结果显示, 血浆β2M水平与CSVD总负荷呈正相关(r=0.687, P<0.001)。使用有序多元因素Logistic回归校正年龄、性别、高血压等混杂因素, 发现血浆β2M(OR=5.253, 95%CI:2.350~11.740, P<0.001)是CSVD总负荷的独立危险因素。结论β2M水平与腔隙性脑梗死患者CSVD总负荷密切相关, 可以作为预测腔隙性脑梗死患者脑小血管病变程度的标记物。
Objective To investigate the relationship between plasma beta-2 microglobulin(β2M)levels and the total magnetic resonance imaging(MRI)burden of cerebral small-vessel disease(CSVD)in elderly patients with lacunar stroke.Methods A total of 93 elderly patients with lacunar stroke admitted to the Department of Neurology,Changzhou Second People's Hospital form August 2018 to August 2019 were enrolled retrospectively,all with complete records of cranial magnetic resonance imaging and plasmaβ2M measurement.According to the total MRI CSVD burden,which ranges from an ordinal score of 0 to 4,patients were divided into 5 groups.Single-factor analysis was used to compare clinical data between the 5 groups.The association between the plasmaβ2M level and total MRI CSVD burden was analyzed by ordered multiple Logistic regression models.Results Among elderly patients with lacunar infarction,19 had a CSVD score of 0,19 had a score of 1,23 had a score of 2,21 had a score of 3,and 11 had a score of 4,with statistically significant differences in age,percentage with diabetes,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,plasmaβ2M,and eGFR between the 5 groups(P<0.05).Spearman correlation analysis showed that plasmaβ2M level was significantly positively correlated with total MRI CSVD burden(r=0.687,P<0.001).In ordered multivariate logistic regression models,after adjustment for possible confounding factors such as age,sex and hypertension,the results demonstrated that plasmaβ2M level(OR=5.253,95%CI:2.350-11.740,P<0.001)was an independent risk factor for total MRI CSVD burden.Conclusions In elderly lacunar stroke patients,the plasmaβ2M level is closely related to the total MRI CSVD burden and can be used as a marker for predicting the severity of lesions.
作者
张晓璞
王思鸿
张敏
Zhang Xiaopu;Wang Sihong;Zhang Min(Department of Neurology,Changzhou Third People's Hospital,Changzhou 213000,China;Department of Neurology,Changzhou Second People's Hospital,Changzhou 213000,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2022年第8期925-929,共5页
Chinese Journal of Geriatrics
基金
江苏省卫生健康委面上项目(H2019051)
常州市卫生健康青苗人才培养工程(CZQM2020073)。
