脑微出血及其分度的相关危险因素分析

Risk factors for cerebral microbleeds and its grading

摘要:

目的 探讨脑微出血及脑微出血分度的危险因素。方法 收集在该院进行磁共振多回波采集重度T2*WI三维梯度回波序列(ESWAN)检查的患者132例，最终纳入资料完整且符合标准的患者118例，分为脑微出血组（82例）和非脑微出血组（36例），脑微出血组再分为轻度组（27例）、中度组（32例）及重度组（23例）。将各组间临床资料及影像学资料进行统计学分析。结果 脑微出血组与非脑微出血组在年龄、性别、高血压、脑梗死、脑出血、舒张压、糖化血红蛋白、同型半胱氨酸、肌酐、纤维蛋白原降解产物及脑白质病变方面比较，差异有统计学意义(P<0.05)；多因素Logistic回归分析发现，舒张压、同型半胱氨酸和脑白质病变是脑微出血发生的危险因素。轻、中、重度组在糖尿病、高血压、脑梗死、糖化血红蛋白、同型半胱氨酸、肌酐及脑白质病变方面比较，差异有统计学意义(P<0.05)；多因素Logistic回归分析发现，高血压和脑白质病变是发生不同程度脑微出血的危险因素。脑白质病变与脑微出血相关性分析显示，发生脑微出血程度与脑白质病变严重程度呈正相关。结论 舒张压、同型半胱氨酸及脑白质病变是脑微出血发生的危险因素。有高血压或脑白质病变患者更易发生严重脑微出血，且脑白质病变越严重发生脑微出血程度越严重。

Abstract:

Objective To investigate the risk factors for cerebral microbleeds and its grading.Methods A total of 132 patients who underwent 3D-enhanced T2 star weighted angiography in our hospital were collected， among whom 118 patients who had complete data and met the criteria were finally included and divided into cerebral microbleeds group with 82 patients and non-cerebral microbleeds group with 36 patients， and the cerebral microbleeds group was further divided into mild group with 27 patients， moderate group with 32 patients， and severe group with 23 patients. A statistical analysis was performed for clinical data and imaging findings.Results There were significant differences between the cerebral microbleeds group and the non-cerebral microbleeds group in age， sex， hypertension， cerebral infarction， cerebral hemorrhage， diastolic pressure， glycosylated hemoglobin， homocysteine， creatinine， fibrinogen degradation product， and leukodystrophy （P<0.05）， and the multivariate logistic regression analysis showed that diastolic pressure， homocysteine， and leukodystrophy were risk factors for the onset of cerebral microbleeds. There were significant differences between the mild， moderate， and severe groups in diabetes， hypertension， cerebral infarction， glycosylated hemoglobin， homocysteine， creatinine， and leukodystrophy （P<0.05）， and the multivariate logistic regression analysis showed that hypertension and leukodystrophy were risk factors for different severities of cerebral microbleeds. The correlation analysis of leukodystrophy and cerebral microbleeds showed that the degree of cerebral microbleeds was positively correlated with the severity of leukodystrophy.Conclusions Diastolic pressure， homocysteine， and leukodystrophy are risk factors for the onset of cerebral microbleeds. Patients who suffer from hypertension or leukodystrophy are more likely to develop severe cerebral microbleeds， and in addition， the degree of cerebral microbleeds increases with the increase in the severity of leukodystrophy.