LAA急性期CMBs检出率及相关危险因素
发布时间：2019-05-15 23:23
【摘要】：目的调查大动脉粥样硬化性脑梗死(large artery atherosclerosis,LAA)急性期脑微出血(cerebral microbleeds,CMBs)的检出率,探讨LAA急性期CMBs发生的相关危险因素。方法1.从2016年4月-2017年2月在辽宁省人民医院神经内科住院的首次发病的,并按照2007年改良版TOAST分型诊断为LAA急性期的患者共78例,对这78例患者于急诊就诊时采用美国GEDiscovery MR3.0T磁共振成像系统进行头颅磁共振成像(magnetic resonance imaging,MRI)平扫、弥散加权成像(diffusion weighted imaging,DWI)、磁共振血管成像(magnetic resonance angiography,MRA)和磁敏感加权成像(susceptibility-weighted imaging,SWI)序列扫描,排除已经发生CMBs的患者6例及进行溶栓治疗的7例患者后,共计65例患者作为研究对象。入院24h内采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS评分)对所有入组患者进行神经功能缺损程度评分。患者禁食12小时后于入院次日晨7时采取空腹肘正中静脉血进行生化检查,包括甘油三酯(triglycerides,TG),总胆固醇(total cholesterol,TC),高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting plasma glucose,FPG)、同型半胱氨酸(homocysteine,HCY)、血尿酸(uric acid,UA)、纤维蛋白原(fibrinogen,FBI)等。入院24小时到1周内再次进行头颅SWI扫描。影像学图像分别由磁共振室及神经科经验丰富的副主任医师阅片,若结论产生分歧,参照CMBs的数量观测量表(Brain Observer Microbleed Scale,BOMBS量表),意见达成一致后记录CMBs情况。2.调查LAA患者急性期CMBs的检出率。3.将所有入组患者根据是否有CMBs分为两组,即:有CMBs组和无CMBs组。选取性别、年龄、体重、吸烟、饮酒、高血压病、2型糖尿病、血脂(TC、TG、HDL-C、LDL-C)、HCY、UA、FBI等因素分别在有无CMBs两组间进行单因素分析,了解以上因素在两组间是否有统计学差异。4.将上述单因素分析后有统计学差异的因素作为自变量,将CMBs作为因变量,进行多因素logistic回归分析,了解CMBs发生的相关独立危险因素。结果1.CMBs的检出率显示:LAA急性期患者CMBs的检出率为60.00%。2.单因素分析显示:有、无CMBs两组间男性、高血压病、HDL-C、UA有统计学差异(P㩳0.05)。3.多因素分析显示:男性(OR=3.844,95%置信区间1.277-11.57,P=0.017)、高血压病(OR=3.204,95%置信区间1.072-9.575,P=0.037),以上两个变量有统计学意义。结论1.LAA急性期患者CMBs的检出率为60%。2.在LAA急性期患者中,男性、高血压病、HDL-C、UA可能是CMBs发生的相关危险因素。3.男性、高血压病是LAA急性期患者CMBs发生的独立危险因素。
[Abstract]:Objective to investigate the detection rate of acute cerebral microhemorrhage (cerebral microbleeds,CMBs) in patients with atherosclerotic cerebral infarction (large artery atherosclerosis,LAA) and to explore the risk factors of CMBs in acute phase of LAA. Method 1. From April 2016 to February 2017, 78 patients were hospitalized in the Department of Neurology, Liaoning Provincial people's Hospital and diagnosed as acute phase of LAA according to the improved version of TOAST classification in 2007. 78 patients were treated with GEDiscovery MR3.0T magnetic resonance imaging (magnetic resonance imaging,MRI), diffusion weighted imaging (diffusion weighted imaging,DWI) and magnetic resonance angiography (magnetic resonance angiography,). MRA) and magnetic sensitive weighted imaging (susceptibility-weighted imaging,SWI) sequence scanning excluded 6 patients with CMBs and 7 patients undergoing thrombolysis therapy. A total of 65 patients were enrolled as subjects of the study. The degree of neurological deficit was scored by National Institutes of Health Stroke scale (National Institutes of Health Stroke Scale,NIHSS) within 24 hours after admission. After fasting for 12 hours, the patients were examined with hollow median elbow vein blood at 7: 00 a.m. after fasting, including triglyceride (triglycerides,TG), total cholesterol (total cholesterol,TC) and high density lipoprotein cholesterol (high density lipoprotein cholesterol,). HDL-C), low density lipoprotein cholesterol (low density lipoprotein cholesterol,LDL-C), fasting blood glucose (fasting plasma glucose,FPG), homocysteine (homocysteine,HCY), serum uric acid (uric acid,UA), fibrinogen (fibrinogen,FBI), etc. SWI scan was performed again within 24 hours to 1 week. The imaging images were read by the deputy chief physician who was experienced in the magnetic resonance room and neurology department respectively. if the conclusion was different, referring to the quantitative observation scale (Brain Observer Microbleed Scale,BOMBS of CMBs), the CMBs was recorded after the agreement was reached. 2. The detection rate of CMBs in acute phase of LAA patients was investigated. 3. All the patients were divided into two groups according to whether they had CMBs, that is, CMBs group and non-CMBs group. Sex, age, weight, smoking, drinking, hypertension, type 2 diabetes mellitus, blood lipid (TC,TG,HDL-C,LDL-C), HCY,UA,FBI and other factors were analyzed by univariate analysis between the two groups with or without CMBs. To find out whether there is a statistical difference between the two groups. 4. Taking the factors with statistical difference as independent variables and CMBs as dependent variables, multivariate logistic regression analysis was carried out to understand the independent risk factors of CMBs. Results the detection rate of 1.CMBs showed that the detection rate of CMBs in patients with acute LAA was 60.00%. Univariate analysis showed that there were significant differences in male, hypertension and HDL-C,UA between the two groups without CMBs (P 鈮，
本文编号：2477844
[Abstract]:Objective to investigate the detection rate of acute cerebral microhemorrhage (cerebral microbleeds,CMBs) in patients with atherosclerotic cerebral infarction (large artery atherosclerosis,LAA) and to explore the risk factors of CMBs in acute phase of LAA. Method 1. From April 2016 to February 2017, 78 patients were hospitalized in the Department of Neurology, Liaoning Provincial people's Hospital and diagnosed as acute phase of LAA according to the improved version of TOAST classification in 2007. 78 patients were treated with GEDiscovery MR3.0T magnetic resonance imaging (magnetic resonance imaging,MRI), diffusion weighted imaging (diffusion weighted imaging,DWI) and magnetic resonance angiography (magnetic resonance angiography,). MRA) and magnetic sensitive weighted imaging (susceptibility-weighted imaging,SWI) sequence scanning excluded 6 patients with CMBs and 7 patients undergoing thrombolysis therapy. A total of 65 patients were enrolled as subjects of the study. The degree of neurological deficit was scored by National Institutes of Health Stroke scale (National Institutes of Health Stroke Scale,NIHSS) within 24 hours after admission. After fasting for 12 hours, the patients were examined with hollow median elbow vein blood at 7: 00 a.m. after fasting, including triglyceride (triglycerides,TG), total cholesterol (total cholesterol,TC) and high density lipoprotein cholesterol (high density lipoprotein cholesterol,). HDL-C), low density lipoprotein cholesterol (low density lipoprotein cholesterol,LDL-C), fasting blood glucose (fasting plasma glucose,FPG), homocysteine (homocysteine,HCY), serum uric acid (uric acid,UA), fibrinogen (fibrinogen,FBI), etc. SWI scan was performed again within 24 hours to 1 week. The imaging images were read by the deputy chief physician who was experienced in the magnetic resonance room and neurology department respectively. if the conclusion was different, referring to the quantitative observation scale (Brain Observer Microbleed Scale,BOMBS of CMBs), the CMBs was recorded after the agreement was reached. 2. The detection rate of CMBs in acute phase of LAA patients was investigated. 3. All the patients were divided into two groups according to whether they had CMBs, that is, CMBs group and non-CMBs group. Sex, age, weight, smoking, drinking, hypertension, type 2 diabetes mellitus, blood lipid (TC,TG,HDL-C,LDL-C), HCY,UA,FBI and other factors were analyzed by univariate analysis between the two groups with or without CMBs. To find out whether there is a statistical difference between the two groups. 4. Taking the factors with statistical difference as independent variables and CMBs as dependent variables, multivariate logistic regression analysis was carried out to understand the independent risk factors of CMBs. Results the detection rate of 1.CMBs showed that the detection rate of CMBs in patients with acute LAA was 60.00%. Univariate analysis showed that there were significant differences in male, hypertension and HDL-C,UA between the two groups without CMBs (P 鈮，
本文编号：2477844
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