社区人群脑微出血与基底节区核团体积的相关性研究

doi:10.3969/j.issn.1673-5765.2021.04.004

摘要/Abstract

摘要：

目的探讨社区人群中脑微出血的部位及负荷与基底节区核团体积的相关性。方法 2013年6月-2016年4月在北京市顺义区5个村进行脑血管病流行病学调查，采集受试者人口学信息、脑血管病危险因素，通过3T MRI采集全脑体积，并自动分割提取基底节区黑质核团（尾状核、苍白球、壳核、丘脑）体积，同时由神经科医师评估脑微出血负荷及分布。用多元线性模型分别分析脑微出血负荷及分布（无脑微出血、1～2个局限皮层脑微出血、≥3个局限皮层脑微出血、1～2个深部/混合脑微出血及≥3个深部/混合脑微出血）与基底节区核团体积的相关性。结果纳入符合标准的受试者997例，平均年龄56.7±9.3岁，男性346例（34.7％）。有脑微出血组基底节、苍白球、尾状核及丘脑体积所占总脑体积的百分比均较无脑微出血组偏低（均P＜0.05）。随着脑微出血负荷增加，基底节、苍白球、尾状核及丘脑体积所占总脑体积的百分比降低（均P＜0.05）。基底节、苍白球、尾状核及丘脑体积所占总脑体积的百分比在不同脑微出血分布三组间差异有统计学意义（均P＜0.05）。多因素模型分析发现，≥3个深部/混合脑微出血与苍白球体积负相关（β=-0.014， P =0.0027），该结果经多重比较后差异仍存在统计学意义。结论社区人群中，横断面研究发现高负荷的深部/混合脑微出血与较小的苍白球体积紧密相关。

文章导读： 本研究显示脑微出血负荷与深部灰质核团体积紧密相关，提示脑小血管病的出血性影像改变可能会加速或加重亚临床神经功能缺失。

关键词: 脑微出血; 脑体积; 基底节区; 苍白球

Abstract:

Objective To investigate the association of the burden and anatomical location of cerebral microbleeds (CMBs) with the volume of basal ganglia (BG) nuclei in community-dwelling population. Methods An epidemiological survey on neurovascular disease was performed in five villages of Shunyi district in Beijing from June 2013 to April 2016. The general demographic information and risk factors of cerebrovascular disease were collected. The volume of the whole brain was collected, and the volume of BG nulei (caudate nucleus, globus pallidus, putamen and thalamus) were automatically segmented and extracted by 3T MRI. Meanwhile, the burden and location of CMBs were evaluated by neurologists. Multivariate linear model was used to analyze the correlation of the burden and distribution of CMBs (the absence of CMBs, 1-2 strictly lobar CMBs, ≥3 strictly lobar CMBs, 1-2 deep/mixed CMBs, ≥3 deep/mixed CMBs) with the volume of BG nuclei. Results A total of 997 subjects were included, with an average age of 56.7±9.3 years old and 346 males (34.7%). The percentage of the volume of BG, globus pallidus, putamen and thalamus in the whole brain in CMBs group were all significantly lower than that in no CMBs group. With the increasing burden of CMBs, the percentage of the volume of BG, globus pallidus, putamen and thalamus in the whole brain decreased (all P <0.05). There was statistical difference in the percentage of the volume of BG, globus pallidus, putamen and thalamus in the whole brain among the three CMBs subgroups. Multivariate linear analysis showed that ≥3 deep/mixed CMBs was negatively correlated with pallidal volume (β =-0.014, P =0.0027). Conclusions In community-dwelling population, higher deep/mixed CMBs burden was closely related to the smaller pallidal volume.

Key words: Cerebral microbleed; Brain volume; Basal ganglia; Pallidum

苏宁，王全，梁新宇，韩菲，周立新，姚明，崔丽英，龚高浪，朱以诚，倪俊. 社区人群脑微出血与基底节区核团体积的相关性研究[J]. 中国卒中杂志, 2021, 16(04): 335-342.

SU Ning, WANG Quan, LIANG Xin-Yu, HAN Fei, ZHOU Li-Xin, YAO Ming, CUI Li-Ying, GONG Gao-Lang, ZHU Yi-Cheng, NI Jun. Correlation between Cerebral Microbleeds and the Volume of Basal Ganglia Nuclei in Community-based Population[J]. Chinese Journal of Stroke, 2021, 16(04): 335-342.

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