青年缺血性卒中患者脑小血管病总负荷的危险因素分析

doi:10.3969/j.issn.1673-5765.2021.05.009

摘要/Abstract

摘要：

目的探讨青年缺血性卒中患者脑小血管病（cerebral small vessel disease，CSVD）总负荷的危险因素。方法回顾性纳入2016年1月-2020年10月于首都医科大学附属北京朝阳医院神经内科连续收治的青年急性缺血性卒中患者。通过MRI评估腔隙、脑白质高信号、扩大的血管周围间隙及脑微出血四种 CSVD影像学标志物，对所有患者的CSVD总负荷进行评分，并根据该评分将患者分为0分组、1分组、2 分组及3～4分组。采用有序logistic回归分析青年缺血性卒中患者CSVD总负荷评分的危险因素。结果共纳入272例患者，平均39.55±5.19岁，男性230例（84.6%）。其中0分组146例（53.7%），1 分组71例（26.1%），2分组40例（14.7%），3～4分组15例（5.5%）。单因素分析结果显示，不同CSVD 总负荷评分组年龄、高血压、肌酐水平差异有统计学意义。有序logistic回归分析显示，增龄（OR 1.110， 95%CI 1.048～1.175）和高血压（OR 2.649，95%CI 1.537～4.559）是CSVD总负荷评分的独立危险因素。结论增龄和高血压是青年缺血性卒中患者CSVD总负荷评分的独立危险因素。

文章导读： 本研究发现增龄和高血压是青年缺血性卒中患者CSVD总负荷评分的独立危险因素。

关键词: 缺血性卒中; 青年; 脑小血管病; 总负荷

Abstract:

Objective To explore the risk factors for the total cerebral small vessel disease (CSVD) burden in young patients with ischemic stroke. Methods From January 2016 to October 2020, the clinical and imaging data of young patients with acute ischemic stroke hospitalized in Department of Neurology of Beijing Chaoyang Hospital, Capital Medical University, were retrospectively analyzed. The total score of CSVD of all the patients were evaluated by assessing the four imaging markers of CSVD, including lacune, white matter hyperintensity, enlarged perivascular space and cerebral microbleed. According to the total score, these patients were divided into four groups of 0 point, 1 point, 2 points, and 3-4 points, respectively. Ordinal logistic regression analysis was used to identify the risk factors for the total CSVD burden in young patients with ischemic stroke. Results A total of 272 patients were enrolled, with the average age of 39.55±5.19 years and 230 males (84.6%), including 146 (53.7%) in 0 score group, 71 (26.1%) in 1 score group, 40 (14.7%) in 2 score group and 15 (5.5%) in 3-4 score group. Univariate analysis showed that there were statistical differences in age, hypertension and creatinine among the four groups. Ordinal logistic regression analysis showed that the aging (OR 1.110, 95%CI 1.048-1.175) and hypertension (OR 2.649, 95%CI 1.537-4.559) were independently associated with the total CSVD burden. Conclusions The increasing age and hypertension were independent risk factors for the total CSVD burden in young patients with ischemic stroke.

Key words: Ischemic stroke; Youth; Cerebral small vessel disease; Total burden

秦伟，胡红梅，李譞婷，王韵，杨淑娜，胡文立. 青年缺血性卒中患者脑小血管病总负荷的危险因素分析[J]. 中国卒中杂志, 2021, 16(05): 470-474.

QIN Wei, HU Hong-Mei, LI Xuan-Ting, WANG Yun, YANG Shu-Na, HU Wen-Li. Analysis on Risk Factors for Total Cerebral Small Vessel Disease Burden in Young Patients with Ischemic Stroke[J]. Chinese Journal of Stroke, 2021, 16(05): 470-474.

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