急性动脉粥样硬化性脑梗死患者血清同型半胱氨酸与脑微出血的相关性研究

发布时间：2018-01-22 16:19

本文关键词： 脑微出血同型半胱氨酸脑小血管病变磁敏感加权成像　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究急性动脉粥样硬化性脑梗死患者血清同型半胱氨酸与脑微出血的相关性。方法:连续收集2015年4月至2016年4月在本院神经内科入院治疗的急性动脉粥样硬化性脑梗死患者129例。根据磁敏感加权成像技术对患者进行分析,将患者按有、无微出血分为两组。记录并比较患者一般临床资料、实验室检验结果、影像学资料特点是否存在差异,采用方差分析、卡方检验、秩和检验比较微出血的危险因素,并运用logistic回归分析脑微出血的独立危险因素。结果:纳入研究的129例脑梗死患者中,共检出微出血39例,占48.8%,CMBs数目1-13个,平均3.31个。其中12名患者CMBs数目1个,18名患者CMBs数目,在2-5个,6名患者CMBs数目≥6个。其次脑叶CMBs占20.5%,深部微出血占51.3%,余下的为混合微出血。根据患者有无CMBS分为两组,两组间高血压(P=0.034)、糖尿病(P=0.002)、陈旧性腔梗(P0.001)、脑白质病(P0.001)、血清同型半胱氨酸水平(P0.001),差异有统计学意义;logistic回归分析显示,陈旧性腔梗(OR值=7.667,P0.001),血清同型半胱氨酸水平(OR值=1.317,P0.001),两组之间比较差异有统计学意义。结论:在神经内科住院的急性动脉粥样硬化性脑梗死患者中,微出血相当常见。磁敏感序列对于微出血的检出有着重要作用。高血压、糖尿病、陈旧性腔梗、脑白质病变、血清同型半胱氨酸水平是急性脑梗死患者发生微出血的相关因素。陈旧性腔梗和血清同型半胱氨酸水平是急性动脉粥样硬化性脑梗死患者微出血的独立危险因素。
[Abstract]:Objective: To study the correlation of microbleeds in serum of patients with acute atherosclerotic cerebral infarction homocysteine and brain. Methods: a total of 129 consecutive cases from April 2015 to April 2016 in the hospital neurology department of our hospital for treatment of patients with acute atherosclerotic cerebral infarction. According to the analysis of magnetic susceptibility weighted imaging for patients, the patients in a micro hemorrhage divided into two. Group. Recorded and compared in patients with clinical data, laboratory tests, imaging characteristics and whether there are differences, using variance analysis, chi square test, rank sum test to compare the micro bleeding risk factors, and using the logistic regression analysis of independent risk factors for cerebral microbleeds. Results: 129 cases of cerebral infarction were included in the study. And there were micro hemorrhage in 39 cases, accounting for 48.8%, the number of CMBs 1-13, an average of 3.31. 12 of the patients CMBs number 1, 18 patients in a number of CMBs, 2-5, 6 The number of patients with CMBs = 6. Second lobe CMBs accounted for 20.5%, deep micro hemorrhage accounted for 51.3%, the rest of the mixed micro hemorrhage. According to the patients with CMBS were divided into two groups, two groups of hypertension (P=0.034), diabetes mellitus (P=0.002), old lacunar infarction (P0.001), cerebral white matter disease (P0.001), the level of serum homocysteine (P0.001), the difference was statistically significant; logistic regression analysis showed that old lacunar infarction (OR = =7.667, P0.001), the level of serum homocysteine (OR = =1.317, P0.001), the difference between the two groups was statistically significant. Conclusions: in patients with acute atherosclerotic neurology the hospital of cerebral microbleeds, quite common. The magnetic sensitive sequence for microbleed detection plays an important role. Hypertension, diabetes mellitus, old lacunar infarction and cerebral white matter lesions, serum homocysteine level is related to factors of micro hemorrhage in patients with acute cerebral infarction. Chen The level of the old cavities and serum homocysteine is an independent risk factor for micro bleeding in patients with acute atherosclerotic cerebral infarction.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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