老年脑微出血分布特点及相关危险因素分析

目的分析老年患者脑微出血（cerebral microbleeds,CMBs）的分布特点及相关危险因素。方法搜集2010年2月-2012年2月本科住院患者217例,年龄60～96（81±6）岁。采集病史及实验室资料,签署知情同意。采用GE公司1.5T扫描仪行常规磁共振及三维梯度回波序列检查,分别记录各个脑叶及脑区的CMBs病灶数。结果本组CMBs检出率为39.2%,随年龄增长CMBs的检出率逐步增高。皮层CMBs病灶多位于额颞叶,深部CMBs病灶多见于深部白质和丘脑。单因素分析显示年龄、高血压病、脑出血史及脑梗死史是CMBs的危险因素。分层分析显示年龄（OR 1.677,95%CI 1.061～2.652,P=0.027）、高血压病（OR 5.415,95%CI 1.723～17.016,P=0.004）及脑出血史（OR 4.065,95%CI 1.129～14.629,P=0.032）与皮层CMBs密切相关。脑梗死史（OR 3.376,95%CI 1.661～6.863,P=0.001）是深部CMBs的独立危险因素。结论不同部位的CMBs相关危险因素不同。

Distribution of cerebral microbleeds in elderly patients and its related risk factors

Objective To study the distribution of cerebral microbleeds （CMBs） in elderly patients and its related risk factors. Methods Medical records and laboratory test data of 217 elderly patients aged 60-96 years admitted to our department from February 2010 to February 2012 were collected. The patients underwent MRI and routine laboratory tests. The number of CMBs in their brain was recorded. Results The detection rate of CMBs was 39.2%, which increased with the age of patients. The CMBs were mainly located in frontotemporal lobe, white matter and thalamus. Single factor analysis showed that age, hypertension, cerebral hemorrhage and infarction history were the risk factors for CMBs. Logistic analysis showed that age （OR=1.677, 95% CI： 1.061- 2.652, P=0.027）, hypertension （OR=5.415, 95% CI： 1.723-17.016, P--0.004） and cerebral hemorrhage history （OR= 4,065, 95% CI： 1.129-14.629, P=0.032） were closely related with CMBs. However, cerebral infarction history （OR=3.376, 95% CI： 1.661-6.863, P=0.001） was an independent risk factor for CMBs. Conclusion The risk factors are different for CMBs at different locations.