急性脑梗死患者脑微出血的危险因素分析

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(P0.05);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(P0.05);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(P0.05);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(P0.05)。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。

Analysis of Risk Factors of Cerebral Microbleeds in Patients with Acute Cerebral Infarction

To analysis the risk factors of cerebral microbleeds(CMBs) in patients with acutecerebral infarction. Methods: Clinical data of 336 patients with acute cerebral infarction was retrospectivelyanalyzed. All the cases were divided into non-CMBs group (n=154) and CMBs group (n=182) according to SWIscan. 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 theNIHSS scores of four sub-groups were compared and analyzed. Results: Compared with those in thenon-CMBs group, cases in CMBs group had higher levels of uric acid and homocysteine, higher incidence rate ofhypertension, diabetes, hyperlipidemia and stroke history (P<0.05). Logistic regression analysis showed thathypertension, hyperglycemia, hypercholesterolemia, stroke history, homocysteine and uric acid levels wereassociated 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 differencewas detected in the incidence rates of CMBs in four sub-groups (P>0.05). No significant differences weredetected in levels of uric acid and homocysteine, NIHSS scores in four sub-groups (P>0.05). Conclusion: Highlevels of homocysteine and uric acid, hypertension, hyperglycemia, hypercholesterolemia and stroke historymaybe risk factors of CMBs in patients with acute cerebral infarction. The location of CMBs distribution has noeffect on the NIHSS score