高龄脑白质疏松症患者危险因素分析及与糖尿病的相关性

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、χ²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。     

高龄患者缺血性脑白质疏松进展的相关危险因素分析

目的 研究高龄(≥80岁)患者缺血性脑白质疏松(LA)进展的特点及相关危险因素.方法 经MRI证实的高龄缺血性LA患者56例,采用Rotterdam Progression Scale评分法,对患者3年的缺血性LA特点及相关危险因素的关系进行对比分析.结果 在高龄患者中缺血性LA进展特点以深部白质为主,其中以额叶进展最为明显(进展前40%升高至进展后52%),其次为顶叶(也由35%升高至36%);高同型半胱氨酸、慢性支气管炎与缺血性LA进展密切相关.结论 高龄患者中缺血性LA进展以深部白质为主,尤其以额叶进展最为明显;高同型半胱氨酸、慢性支气管炎是高龄患者缺血性LA进展的相对危险因素.

Abstract：

Objective To study the features and risk factors of ischemic leukoaraiosis (LA) progression in elderly patients aged 80 years and over. Methods The 56 elderly patients with ischemic LA confirmed by MRI were enrolled in this study. The characteristics and risk factors of ischemic LA were comparatively analyzed between baseline and 3 years later by single and multi-variable logistic regression analysis. Results Ischemic LA progressed mostly in the subcortical white matter in elderly patients, especially the frontal lobes (progression of white matter lesion was present in 40% in the frontal lobes at baseline and 52% after 3 years), followed by the parietal lobes (35% at baseline and 36% after 3 years); Furthermore, previous high homocysteine (Hcy) and chronic bronchitis were risk factors of ischemic LA progression. Conclusions Ischemic LA progresses mostly in the subcortical white matter in the elderly, especially the frontal lobes; High Hcy and chronic bronchitis are risk factors of ischemic LA progression in elderly patients.     

脑白质疏松症严重程度与其发生的相关因素分析

目的评价脑白质疏松症(LA)临床相关危险因素之间的相关性及预测病情的价值。方法回顾性调查行头颅MRI检查的住院患者218例,根据诊断分为非LA 56例和LA 162例,LA患者又根据Fazekas等级分类标准,分为轻度LA 52例,中度LA 53例及重度LA 57例。对相关危险因素(年龄、性别、既往疾病、血脂等)分别进行逐个单因素和多因素logistic回归分析。结果 TC、高LDL-C、高同型半胱氨酸与轻度LA发生有相关性(P<0.05,P<0.01)。年龄≥70岁、高血压3级、吸烟、高TC,高同型半胱氨酸与中度LA的发生有相关性(P<0.05,P<0.01)。年龄≥70岁、高血压3级、高LDL -C、高同型半胱氨酸、颈动脉内膜中层厚度增厚与重度LA的发生有相关性(P<0.05)。结论年龄≥70岁、高血压3级、高同型半胱氨酸、高TC、高LDL-C、吸烟及颈动脉内膜中层厚度增厚是LA的独立发病危险因素。中度LA和重度LA与年龄≥70岁、高血压3级及颈动脉内膜中层厚度增厚有明显相关性。     

高龄老年人不同程度脑白质损害的危险因素分析

目的 初步探讨不同程度脑白质损害(white matter lesions,WML)高龄患者的独立危险因素,为WML的进展提供预测依据.方法 根据Fazekas分级标准将151例74～93岁高龄老年人分为无白质损害组(对照组)、轻度脑白质损害组(轻度WML组)、中重度脑白质损害组(中重度WML组),采用单因素方差分析和多因素Logistic回归分析三组间认知评分、血管危险因素、脑动脉硬化和脑血流动力学、神经解剖等各项指标之间差异及独立危险因素.结果 三组间单因素方差分析显示,认知评分(F=48.595,P=0.000)、高血压(x2=7.052,P=0.029)、吸烟(x2=19.476,P=0.000)、总胆固醇(F=3.086,P=0.049)、Crouse积分(F=3.968,P=0.021)及多项脑萎缩指标差异有统计学意义.轻度WML组患者与对照组间多因素Logistic回归分析结果表明,吸烟(OR 2.031,95%CI 1.244～1.317)、腔隙性梗死(LI)数目(OR 2.031,95%CI L 316～4.015)、总胆固醇(OR 1.610,95%CI 0.972～2.668)为独立危险因素(P＜0.05);中重度WML组与轻度WML组间回归分析结果表明,认知评分(OR 0.276,95%CI 0.143～0.532)、吸烟(OR 2.262,95%CI 1.260～4.059)、大脑外侧裂比(OR 1.954,95%CI 1.013～3.768)为独立危险因素(P＜0.05).中重度WML组患者与对照组间回归分析结果显示,认知评分(OR 0.091,95%CI 0.030～0.273)、尾状核指数(OR 2.511,95%CI 1.147～5.499)、Crouse积分(OR 2.304,95%CI 1.127～4.712)、LI数目(OR 2.200,95%CI 1.028～4.707),为独立危险因素(P＜0.05).结论 轻度WML患者在认知功能、脑动脉硬化及脑萎缩等方面改变不显著,而中重度WML患者表现显著的认知功能障碍、脑动脉硬化和脑萎缩.与对照组比较,认知评分、尾状核指数、Crouse积分、LI数目是中重度WML患者的独立危险因素.

Abstract：

Objective To investigate the independent risk factors of cerebral white matter lesions (WML) of different degrees in the elderly aged 80 years and over,and provide the evidences for forecasting the prognosis of WML.Methods Brain magnetic resonance images (MRI) findings in 151 people aged 74 to 93 years were collected and analyzed.According to the severity of WML in brain MRI using the Fazekas Scale,the persons were divided into non-WML (control) group,mildWML (grade 1 WML) group and moderate-to-severe WML (grade 2 WML) group.The cognitive score,vascular risk factors,cerebral hemodynamic and arteriosclerotic index,and radiological features were compared among the three groups.Subsequent one-way ANOVA and multivariate logistic analysis were performed to determine the statistically significant factors and the independent risk factors among groups.Results The statistically significant factors with one-way ANOVA analysis among the three groups were cognitive performance (F = 48.595,P = 0.000),hypertension (x2 =7.052,P=0.029),cigarette history (x2 = 19.476,P= 0.000),cholesterol (TC) (F= 3.086,P=0.049),Crouse score (F=3.968,P=0.021) and multiple cerebral atrophy indexes.When compared with control group,cigarette history (OR 2.031,95%CI 1.244-1.317),lacunar infarction (LI)numbers (OR 2.031,95%CI 1.316-4.015) and cholesterol (OR 1.610,95%CI 0.972-2.668) were independent risk factors in grade 1 WML group (all P＜0.05).The independent risk factors between grade 1 and 2 WML group were cognitive performance (OR 0.276,95%CI 0.143-0.532),cigarette history (OR 2.262,95% CI 1.260-4.059),and sylvian fissure ratio (SFR) (OR 1.954,95% CI 1.013-3.768) (all P＜0.05).The independent risk factors between the grade 2 WML group and control group were cognitive performance (OR 0.091,95%CI 0.030-0.273),bicoudate ratio (BCR)(OR 2.511,95%CI 1.147-5.499),Crouse score (OR 2.304,95%CI1.127-4.712)and LI numbers (OR 2.200,95%CI 1.028-4.707) (all P＜0.05).Conclusions Mild WML patients have no significant abnormalities in cognition,brain atrophy and cerebral atherosclerosis.Moderate to severe WML patients manifest remarkable cognitive disorder,cerebral atherosclerosis and brain atrophy.Compared with the controls,cognitive performance,BCR,Crouse score,LI numbers were the independent risk factors for moderate-severe WML patients.     

老老年缺血性脑白质病变患者严重程度与血清胱抑素C的关系

目的探讨老老年(85岁)缺血性脑白质病变患者严重程度与血清胱抑素C的相关性。方法选择行头颅MRI检查的缺血性脑白质病变患者115例,根据年龄相关的白质改变量表进行分组,轻度组(1~4分)42例,中度组(5~8分)42例,重度组(≥9分)31例。收集各组患者年龄、高血压、糖尿病、肾脏疾病、冠心病、慢性支气管炎、高脂血症、腔隙性脑梗死等病史,血清胱抑素C、肌酐、尿素等指标并进行比较,采用有序多分类logistic回归分析血清胱抑素C与缺血性脑白质病变的相关性。结果与轻度组比较,中度组和重度组糖尿病比例明显升高(P0.05,P0.01)。重度组血清胱抑素C水平明显高于轻度组和中度组[(1.7±1.8)mg/L vs(0.7±0.6)mg/L、(0.9±0.6)mg/L,P0.05]。校正年龄、高血压、糖尿病等因素后,多因素logistic回归分析显示,血清胱抑素C水平是缺血性脑白质病变严重程度增加的独立危险因素(OR=2.743,95%CI:0.497~1.527,P=0.000)。Spearman等级相关分析显示,血清胱抑素C水平升高与缺血性脑白质病变严重程度呈正相关(r=0.344,P=0.000)。结论血清胱抑素C水平升高可能与老老年患者缺血性脑白质病变的严重程度相关。     

高龄老年人不同程度脑白质损害的危险因素分析

Objective To investigate the independent risk factors of cerebral white matter lesions (WML) of different degrees in the elderly aged 80 years and over,and provide the evidences for forecasting the prognosis of WML.Methods Brain magnetic resonance images (MRI) findings in 151 people aged 74 to 93 years were collected and analyzed.According to the severity of WML in brain MRI using the Fazekas Scale,the persons were divided into non-WML (control) group,mildWML (grade 1 WML) group and moderate-to-severe WML (grade 2 WML) group.The cognitive score,vascular risk factors,cerebral hemodynamic and arteriosclerotic index,and radiological features were compared among the three groups.Subsequent one-way ANOVA and multivariate logistic analysis were performed to determine the statistically significant factors and the independent risk factors among groups.Results The statistically significant factors with one-way ANOVA analysis among the three groups were cognitive performance (F = 48.595,P = 0.000),hypertension (x2 =7.052,P=0.029),cigarette history (x2 = 19.476,P= 0.000),cholesterol (TC) (F= 3.086,P=0.049),Crouse score (F=3.968,P=0.021) and multiple cerebral atrophy indexes.When compared with control group,cigarette history (OR 2.031,95%CI 1.244-1.317),lacunar infarction (LI)numbers (OR 2.031,95%CI 1.316-4.015) and cholesterol (OR 1.610,95%CI 0.972-2.668) were independent risk factors in grade 1 WML group (all P＜0.05).The independent risk factors between grade 1 and 2 WML group were cognitive performance (OR 0.276,95%CI 0.143-0.532),cigarette history (OR 2.262,95% CI 1.260-4.059),and sylvian fissure ratio (SFR) (OR 1.954,95% CI 1.013-3.768) (all P＜0.05).The independent risk factors between the grade 2 WML group and control group were cognitive performance (OR 0.091,95%CI 0.030-0.273),bicoudate ratio (BCR)(OR 2.511,95%CI 1.147-5.499),Crouse score (OR 2.304,95%CI1.127-4.712)and LI numbers (OR 2.200,95%CI 1.028-4.707) (all P＜0.05).Conclusions Mild WML patients have no significant abnormalities in cognition,brain atrophy and cerebral atherosclerosis.Moderate to severe WML patients manifest remarkable cognitive disorder,cerebral atherosclerosis and brain atrophy.Compared with the controls,cognitive performance,BCR,Crouse score,LI numbers were the independent risk factors for moderate-severe WML patients.     

高龄老年人不同程度脑白质损害的危险因素分析

Objective To investigate the independent risk factors of cerebral white matter lesions (WML) of different degrees in the elderly aged 80 years and over,and provide the evidences for forecasting the prognosis of WML.Methods Brain magnetic resonance images (MRI) findings in 151 people aged 74 to 93 years were collected and analyzed.According to the severity of WML in brain MRI using the Fazekas Scale,the persons were divided into non-WML (control) group,mildWML (grade 1 WML) group and moderate-to-severe WML (grade 2 WML) group.The cognitive score,vascular risk factors,cerebral hemodynamic and arteriosclerotic index,and radiological features were compared among the three groups.Subsequent one-way ANOVA and multivariate logistic analysis were performed to determine the statistically significant factors and the independent risk factors among groups.Results The statistically significant factors with one-way ANOVA analysis among the three groups were cognitive performance (F = 48.595,P = 0.000),hypertension (x2 =7.052,P=0.029),cigarette history (x2 = 19.476,P= 0.000),cholesterol (TC) (F= 3.086,P=0.049),Crouse score (F=3.968,P=0.021) and multiple cerebral atrophy indexes.When compared with control group,cigarette history (OR 2.031,95%CI 1.244-1.317),lacunar infarction (LI)numbers (OR 2.031,95%CI 1.316-4.015) and cholesterol (OR 1.610,95%CI 0.972-2.668) were independent risk factors in grade 1 WML group (all P＜0.05).The independent risk factors between grade 1 and 2 WML group were cognitive performance (OR 0.276,95%CI 0.143-0.532),cigarette history (OR 2.262,95% CI 1.260-4.059),and sylvian fissure ratio (SFR) (OR 1.954,95% CI 1.013-3.768) (all P＜0.05).The independent risk factors between the grade 2 WML group and control group were cognitive performance (OR 0.091,95%CI 0.030-0.273),bicoudate ratio (BCR)(OR 2.511,95%CI 1.147-5.499),Crouse score (OR 2.304,95%CI1.127-4.712)and LI numbers (OR 2.200,95%CI 1.028-4.707) (all P＜0.05).Conclusions Mild WML patients have no significant abnormalities in cognition,brain atrophy and cerebral atherosclerosis.Moderate to severe WML patients manifest remarkable cognitive disorder,cerebral atherosclerosis and brain atrophy.Compared with the controls,cognitive performance,BCR,Crouse score,LI numbers were the independent risk factors for moderate-severe WML patients.     

不对称性脑白质疏松症的危险因素分析

目的 分析不对称性脑白质疏松症的相关危险因素,探讨不对称性脑白质疏松症的患病率及发病机制.方法 连续收集266例年龄40岁以上患者资料,所有患者行头颅MR1及颈动脉超声检查,依据头颅MRI诊断脑白质疏松症112例.依据MRI-FLAIR半定量分析方法 计算白质高信号的体积并对腔隙性梗死灶计数,白质高信号重侧与轻侧比率>...     

年龄相关性脑白质改变:影像学、危险因素和临床意义

年龄相关性脑白质改变(age-related white matter changes,ARWMC)被认为是小动脉硬化性小血管病的表现,与高龄和血管危险因素有关.脑白质改变(white matter changes,WMC)已被公认为脑小血管病的表现之一,是老年人认知损害和功能丧失的病理学基础.研究表明,但WMC发展到一定程度时,会出现许多临床症状,包括认知损害、痴呆、抑郁、步态障碍、尿失禁,并与卒中和死亡风险增高相关.     

老年高血压患者脑白质病变在磁共振序列中的半定量评估

目的前瞻性分析老年高血压患者脑白质病变(WML)的MRI特征。方法选择2017年4～12月在本院就诊的老年患者80例,依据2017高血压临床诊断指南,将患者分为血压正常组20例和高血压组60例,高血压组又分为血压升高组20例、高血压1级组20例、高血压2级组20例。患者均行头颅T_1WI、T_2WI、液体衰减反转恢复(FLAIR)序列检查,应用Scheltens视觉评定量表评定患者脑室旁白质评分(0～6分)、深部脑白质评分(0～24分)、基底节白质区评分(0～30分)和幕下白质区评分(0～24分)等,并进行前瞻性分析。结果 4组脑室旁白质枕角评分、深部脑白质额叶、顶叶、枕叶和颞叶评分比较,差异均有统计学意义(P<0.05,P<0.01),4组脑室旁白质额角和侧脑室旁评分、基底节白质区和幕下白质区各处评分比较,差异均无统计学意义(P>0.05)。4组脑室旁白质、基底节白质区和幕下白质区评分WML百分率比较,差异无统计学意义(P>0.05),血压正常组、血压升高组、高血压1级组和高血压2级组深部脑白质评分WML百分率比较,差异有统计学意义(16.0%vs 24.6%vs 42.9%vs 49.4%,P=0.001);且血压升高组较血压正常组明显升高;高血压1级组和高血压2级组较血压升高组均明显升高(P=0.01,P=0.03,P=0.02)。高血压2级组较血压正常组脑室旁白质评分WML百分率明显升高(35.0%vs 56.7%,P=0.03)。血压正常组与高血压组脑室旁白质中的枕角评分和深部脑白质评分WML百分率比较,差异有统计学意义(12.5%vs 17.8%,P=0.016;16.0%vs 39.0%,P=0.001)。结论 3.0T MRI FLAIR序列可以半定量评估高血压患者WML进展程度,可为临床提供更有针对性地干预及治疗方案。     

原发性高血压患者24小时动态血压变异性与缺血性脑白质病变的相关性研究

目的分析原发性高血压患者24h血压变异性与缺血性脑白质病变(white matter lesions,WML)的相关性。方法收集2017年1～6月北京大学人民医院接受诊治的原发性高血压患者126例,所有患者行24h动态血压监测和头颅MRI检查,根据Fazekas量表作为诊断WML程度的依据,分为无-轻度WML组42例和中-重度WML组84例。收集2组一般临床资料,对患者24h动态血压各时段(24h、昼间、夜间)收缩压、舒张压及收缩压、舒张压标准差和变异系数进行分析。结果中-重度WML组年龄明显高于无-轻度WML组[(66.02±11.11)岁vs(60.00±10.57)岁,P=0.000],HDL-C水平明显低于无-轻度WML组[(1.08±0.02)mmol/L vs (1.25±0.26)mmol/L,P=0.000]。中-重度WML组昼间收缩压、夜间收缩压、昼间收缩压标准差、昼间舒张压标准差、昼间收缩压变异系数和昼间舒张压变异系数明显高于无-轻度WML组,差异有统计学意义(P0.05,P0.01)。logistic回归分析显示,年龄、昼间收缩压标准差与WML严重程度呈正相关(OR=1.077,95%CI:1.025～1.133,P=0.012;OR=1.251,95%CI:1.014～1.543,P=0.005)。结论原发性高血压患者WML严重程度与昼间收缩压标准差、年龄密切相关。     

卒中患者脑白质疏松的危险因素

目的 探讨脑白质疏松(leukoaraiosis,LA)的危险因素.方法 回顾性收集卒中患者的临床和影像学资料,根据MRI结果将脑白质疏松分为脑室周围LA和皮质下LA,并进行计分和分级.结果 共纳入113例卒中患者,其中男性74例,女性39例,平均(61.33±1.32)岁.有脑室周围LA患者(n=86)的年龄[(65...     

大动脉粥样硬化性卒中患者脑白质疏松危险因素分析

目的探讨大动脉粥样硬化性卒中(LAA)患者脑白质疏松(LA)的危险因素。方法回顾性分析312例经改良急性卒中Org 10172治疗试验(TOAST)分型的LAA患者的临床资料(年龄、性别及高血压、糖尿病、吸烟、血脂水平、同型半胱氨酸水平、狭窄或闭塞脑动脉数等),采用年龄相关性白质改变(ARWMC)量表评估LA,依据MRI T2加权像或液体衰减反转恢复(FLAIR)序列将患者分为无LA组72例及有LA组240例,同时依据ARWMC评分将有LA组患者分为轻度LA组140例、中度LA组42例及重度LA组58例,并对患者多种危险因素进行单因素和多因素Logistic回归分析。结果 (1)312例LAA患者中男227例(72.8%),平均年龄(64±11)岁,其中240例(76.9%)存在LA。多因素Logistic回归分析显示年龄(OR=2.911,95%CI:1.647~5.146,P0.01)、高血压(OR=2.583,95%CI:1.373~4.857,P0.01)、糖尿病(OR=1.882,95%CI:1.058~3.348,P0.05)、狭窄或闭塞动脉支数(OR=1.851,95%CI:1.018~3.367,P0.05)、腔隙性脑梗死(LI)(OR=1.493,95%CI:1.202~1.853,P0.01)是LA的危险因素。(2)不同严重程度LA组患者临床资料比较显示,3组间年龄、高血压、糖尿病、狭窄或闭塞动脉支数及LI差异有统计学意义(均P0.05)。结论年龄、高血压、糖尿病、狭窄或闭塞动脉数及LI是LAA患者LA的危险因素,且与LA的严重程度相关。     

脑白质疏松症相关因素分析

脑白质疏松症是由多种病因引起的一组影像学所描述的临床综合征,磁共振成像T1加权像呈等或低信号,T2加权像呈高信号。国外报道它占卒中病人的3%~44%[1],此种改变可见于多种疾病,也可见于正常老年人。为探讨脑白质疏松症的发生机制、危险凶素、临床表现,现对我科病房中两年来78例脑白质疏松症患者与同期132例非白质疏松症患者的临床资料进行分析对比,现报道如下。     

影响脑微出血严重程度的危险因素分析

目的探讨影响脑微出血严重程度的危险因素。方法连续纳入2011年8月-2015年3月在北京军区总医院经头部磁共振磁敏感加权成像（SWI）证实有脑微出血（CMBs）的患者200例,根据SWI上CMBs的病灶数将其分为轻度（1～5个）组111例,中度（6～15个）组86例,重度（≥15个）组30例。分析影响CMBs严重程度的危险因素。结果①单因素分析结果显示,3组患者性别、年龄、糖尿病、心房颤动、高血压、颈动脉粥样硬化、凝血功能异常及抗血小板聚集治疗差异无统计学意义（P〉0．05）。微出血的程度随腔隙性脑梗死灶数量、脑白质疏松程度的增加而增加,脑出血率也随着CMBs程度的加重而增加,3组患者差异有统计学意义（P〈0．05）。中、重度组合并后与轻度组比较,差异仍有统计学意义（P〈0．05）。@Spearman相关分析显示,CMBs程度与腔隙性脑梗死灶数量（r=0．392,P〈0．01）及脑白质疏松程度（r=0．362,P〈0．01）呈正相关。③将中重度组合并后进行多因素Logistic回归分析显示,腔隙性脑梗死灶数量（OR=d．259,95％CI：3．064～5．620,P=0．001）、脑白质疏松程度（OR=3．250,95％CI：2．351～4．665,P=0．005）是影响CMBs程度的独立危险因素。CMBs程度与脑出血呈正相关（OR=1．813,95％CI：1．788～2．581,P=0．029）。结论脑白质疏松程度、腔隙性脑梗死数目及脑出血与CMBs的严重程度密切相关。     

脑白质疏松与眼底血管病变的相关性分析

目的探讨脑白质疏松(leukoaraiosis,LA)与眼底血管病变的相关性。方法选择行头颅MRI和眼底检查的脑梗死患者168例,分为LA组108例和非LA组60例,比较2组临床资料,进行logistic回归分析。结果 LA组患者高血压、腔隙性脑梗死发生率及血浆同型半胱氨酸水平、C反应蛋白水平均高于非LA组,差异有统计学意义(P<0.05));LA组视网膜动静脉交叉征发生率为70.4%,蜡样渗出的发生率为31.5%,分别高于非LA组的38.3%和15.0%(P<0.05,P<0.01)。存在视网膜动静脉交叉征的患者LA发生率是无此症患者的4.14倍(OR=4.14,95%CI:1.67～10.28);存在蜡样渗出的患者LA的发生率是无蜡样渗出患者的1.81倍(OR=1.81,95%CI:0.56～5.87);年龄、高血压、腔隙性脑梗死是眼底血管病变的独立影响因素(OR=4.02,95%CI:1.59～10.13;OR=4.22,95%CI:1.93～25.94,P<0.05)。结论眼底视网膜病变中的动静脉交叉征和蜡样渗出是LA的危险因素。年龄、血压和腔隙性脑梗死与眼底病变及LA相关。     

脑白质疏松与抑郁发生率的相关性研究

目的分析不同程度脑白质疏松(LA)与抑郁发生的相关性。方法选择经头颅MRI检查确诊的LA患者132例为LA组;同期收集132例有头痛、头晕的健康体检者为非LA组。所有患者均进行汉密尔顿抑郁量表评分,比较2组抑郁的发生率,并分析LA的严重程度与抑郁的相关性。结果与非LA组比较,LA组抑郁发生率明显升高(21.2%vs 62.9%,P<0.01)。与非LA组比较,LA组轻度抑郁、中度抑郁和重度抑郁汉密尔顿抑郁量表评分明显升高,差异有统计学意义[(9±2)分vs(12±2)分和(15±2)分和(21±2)分,P<0.01]。logistic回归分析显示,年龄(OR=9.550,95%CI:1.174².050,P=0.002)、高血压(OR=10.330,95%CI:1.4982.050,P=0.002)、高血压(OR=10.330,95%CI:1.498⁵.300,P=0.001)、腔隙性脑梗死(OR=16.514,95%CI:1.8245.300,P=0.001)、腔隙性脑梗死(OR=16.514,95%CI:1.824⁵.590,P=0.000)、LA(OR=4.933,95%CI:1.0815.590,P=0.000)、LA(OR=4.933,95%CI:1.081³.498,P=0.026)为抑郁的危险因素。结论 LA的不同严重程度与抑郁有关。     

记忆损害型帕金森病轻度认知障碍患者脑白质疏松及脑血管危险因素的分析

目的探讨脑白质疏松及脑血管危险因素在记忆损害型帕金森病(PD)轻度认知功能障碍患者中的影响。方法根据神经心理学测验结果,将102例PD患者分为记忆受损组30例、非记忆受损组35例和认知正常组37例,运用Scheltens视觉评定量表评估脑白质疏松程度,比较3组侧脑室旁、脑深部白质、基底节区、小脑幕下区脑白质疏松程度差异;分析脑血管危险因素在3组中的影响。运用多元线性回归分析脑白质疏松和脑血管危险因素等对记忆损害型PD轻度认知功能障碍患者的影响。结果记忆受损组额叶高信号、侧脑室旁白质高信号较认知正常组和非记忆受损组明显增高(P<0.05)。与认知正常组和非记忆受损组比较,记忆受损组TC明显升高[(5.87±0.81)mmol/L vs(3.86±1.10)mmol/L,(4.82±1.08)mmol/L],HDL-C明显降低[(1.17±0.24)mmol/L vs(1.26±0.53)mmol/L,(1.27±0.36)mmol/L,P<0.05]。多元线性回归分析显示,侧脑室旁脑白质高信号、TC与视觉再生呈负相关(β=-0.341,P=0.000;β=-0.212,P=0.030),教育程度与视觉再生呈正相关(β=0.201,P=0.038)。结论侧脑室旁脑白质疏松、高TC和高密度脂蛋白降低可能会导致PD-MCI患者的记忆受损。     

神经内科住院病人脑白质疏松的危险因素分析

目的探讨神经内科病人脑白质疏松(WMLs)的危险因素。方法回顾2010年1月至2010年12月神经内科行头颅MR及MRA检查485位病人MR影像学资料与临床病史及实验室检查等资料,并进行相关分析。结果相关风险因素分析中与WMLs有统计学意义的相关变量为年龄、高血压史、脑卒中史、脑动脉硬化。单因素水平分析中性别、年龄、高血压史、入院收缩压及脑动脉硬化等变量对WMLs的组间差异有统计学意义。结论年龄、部分血管风险因子及卒中史为WMLs的相关风险因素;不同的危险因素可能造成WMLs的形态差异。