沙漠化地区缺血性脱髓鞘性脑白质病变危险因素研究

目的 回顾性研究武威市沙漠化地区缺血性脱髓鞘性脑白质病变的危险因素，为临床中预防沙漠地区缺血性脱髓鞘性脑白质病变的发生提供理论依据。方法 收集武威市人民医院神经内科2011年1月-2015年12月住院或门诊筛查出的缺血性脑血管病变患者共500例。按不同居住地、不同危险因素对所筛选病例进行分析。采用多因素Logistic回归分析缺血性脱髓鞘性脑白质病变患者的相关危险因素。结果 沙漠组的缺血性脱髓鞘性脑白质病变发生率为62.4%，平原组的缺血性脱髓鞘性脑白质病变发生率为49.6%；沙漠组中脑白质病变中重度病变占22.4%，平原组的脑白质病变中重度病变占8.4%。多因素分析结果表示沙漠化天气、吸烟、饮酒、糖尿病、高血压、脂代谢异常、颈动脉硬化、高同型半胱氨酸是加重缺血性脑白质病变的危险因素。结论 沙漠化地区缺血性脱髓鞘脑白质病变的发生率较平原地区偏高，以重度病变为主。

Study on Ischemic Demyelinating Cerebral White Matter Lesions Related Risk Factors in Desertification Areas

Objective To study the risk factors of ischemic demyelinating cerebral white matter lesions in Wuwei desert area retrospectively, so as to provide a theoretical evidence for the clinical prevention of occurrence of ischemic demyelinating cerebral white matter lesions in desert area . Methods A total of 500 patients with ischemic cerebrovascular diseases were selected from the department of neurology of wuwei people's hospital from January 2011 to December,2015. The screened cases were analyzed according to different living places and different risk factors. Multivariate logistic regression was used to analyze the risk factors associated with ischemic demyelinating white matter lesions. Results In desert group, ischemic demyelinating brain white matter disease incidence rate was 62.4%;while in plain group, the ischemic demyelinating leukoencephalopathy incidence rate was 49.6%. In desert group, cerebral white matter severe lesions was 22.4%; in plain group , cerebral white matter severe lesions was 8.4%. Multivariate analysis showed that desertification weather, smoking, alcohol consumption, diabetes mellitus, hypertension, lipid metabolism abnormality, carotid atherosclerosis and homocysteine were risk factors for aggravation of ischemic brain white matter lesions. Conclusion The incidence of ischemic demyelinating white matter lesions in desert areas was higher than that in plain areas, and majority of them were severe lesions.