《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (09): 820-823.

• 专题 • 上一篇    下一篇

脑梗死患者脑微量出血的发生及危险因素分析

彭清1; 黄一宁1; 孙葳1; 刘冉1; 刘文宏1,2   

  1. 1.北京大学第一医院神经内科,北京市 100034;2.北京世纪坛医院神经内科,北京市 100038
  • 收稿日期:2008-04-29 出版日期:2008-09-01 发布日期:2008-09-01

Incidence and Risk Factors of Cerebral Microbleeds in Patients with Ischemic Stroke

PENG Qing, HUANG Yi-ning, SUN Wei, et al   

  1. Department of Neurology, Peking University First Hospital, Beijing 100034, China
  • Received:2008-04-29 Published:2008-09-01 Online:2008-09-01

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摘要： 目的探讨脑梗死患者脑微量出血(CMB)的发生情况及其危险因素。方法收集1～6个月内脑梗死患者,详细记录临床资料,采用临床资料盲法对CMB、腔隙性梗死及脑白质病变(WML)进行评估。采用Logistic回归分析CMB发生的独立危险因素。结果共收集了636例患者。250例(39.3%)存在CMB。≤50岁、50～65岁及>65岁组CMB发生率依次为27.2%、38.1%和47.6%(P<0.05)。腔隙性梗死数目越多,CMB发生率越高(P<0.05)。在无WML、轻度、中度和重度WML患者中CMB的发生率依次为21.9%、33.8%、46.9%和63.1%,组间比较均有显著性差异(P<0.05)。Logistic回归分析显示,高血压病史(OR=1.523,95%CI 1.019～2.276)、WML程度(OR=1.535,95%CI 1.258～1.874)和腔隙性梗死程度(OR=1.517,95%CI 1.087～2.118)是发生CMB的独立危险因素。结论脑梗死患者中CMB发生率较高。年龄越大、腔隙性梗死和WML程度越严重,CMB的发生率越高。高血压病史、WML和腔隙性梗死程度是脑梗死患者发生CMB的独立危险因素。

关键词: 脑微量出血(CMB), 脑梗死, 缺血性卒中, 危险因素

Abstract: Objective To investigate the incidence and risk factors of cerebral microbleeds(CMB) in ischemic stroke patients.Methods Patients with cerebral infarction for 1～6 months were recruited.Clinical data were recorded.MRI was reviewed blindly to determine the number of CMB and lacunar infarcts and the white matter lesions(WML).The independent risk factors of CMB were analyzed with the Logistic multivariable regression.Results 636 subjects were included.CMB were found in 250 cases(39.3%).The incidence of CMB in patients of ≤50,50～65 and >65 years old were 27.2%,38.1% and 47.6% respectively(P<0.05).CMB was more frequent in patients with more lacunar infarcts(P<0.05).The incidence of CMB in patients with negative,mild,moderate and severe WML were 21.9%,33.8%,46.9%and 63.1% respectively(P<0.05).Logistic regression analysis showed that history of hypertension(OR=1.523,95% CI 1.019～2.276),severity of WML(OR=1.535,95% CI 1.258～1.874) and lacunar infarcts(OR=1.517,95% CI 1.087～2.118) were the independent risk factors for presence of CMB.Conclusion CMB was frequent in ischemic stroke.The frequency of CMB increased with aging,grade of lacunar infarcts and WML.History of hypertension,severity of WML and lacunar infarcts were the independent risk factors for CMB presence.

Key words: cerebral microbleed, cerebral infarction, ischemic stroke, risk factors