门诊非痴呆患者单纯脑白质疏松的年龄特征

目的 探讨门诊非痴呆患者单纯脑白质疏松的年龄特征.方法 选择首都医科大学附属北京天坛医院神经内科门诊首诊患者,年龄>40岁,未服用降脂药及B族维生素,简易精神状态量表(MMSE)>24分.依据MRI确定脑白质疏松并排除腔隙性病灶、皮层梗死灶.脑白质疏松组138例,脑内仅存在白质疏松病灶,对照组124例,无脑内病灶.结果 单因素分析发现,单纯脑白质疏松组患者年龄明显大于对照组(P<0.001).调整性别、血管危险因素后,多变量lngistics回归分析发现,年龄仍然与单纯脑白质疏松独立相关(OR 1.080,95%CI 1.042～1.120,P=0.001).对年龄进行分层发现,60岁年龄层及>70岁年龄层发生脑白质疏松的风险性是40岁年龄层的2.693(95%CI1.103～6.575)倍及13.527(95%CI 3.319～55.131)倍.结论 年龄是单纯脑白质疏松的确定危险因素,60岁以后脑白质疏松的风险性大幅增加.

Age features of pure leukoaraiosis in non-demented outpatients

Objective To investigate the aging features of pure leukoaraiosis (LA) in nondemented outpatients. Methods The outpatients with age older than 40 years, without taking cholesterol lowering and B vitamin medications and with mini-mental state examination more than 24 scores were selected from July 2008 to December. 2009 in Beijing Tiantan Hospital. LA was defined with MRI. Patients were classified into two groups i. e. LA group consisting of 138 patients with leukoaraiosis but without lacunar lesions and cortical infarcts and a control group consisting of 124 patients without any lesion in brain. Age and other vascular risk factors were also investigated. Results Age of the patients in the LA group was significantly higher than that in the control group (P< 0.001). Multivariable logistic regression analysis showed that age was independently associated with pure LA ( OR 1.080, 95% CI 1.042-1.120), after adjusting sex, vascular risk factors and presence of atherosclerosis in cervical arteries. If age-stratification was further considered, logistic regression analysis showed that OR (95% CI) for LA was 2.693 (95% CI 1.103-6.575) in a 60-69 year group and 13. 527(95%CI 3.319-55.131) in a≥70 year group as compared with a 40-49 year group. Conclusion Age is a determining risk factor for pure LA and patients with age older than 60 years are at high risk of LA.