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时间:2019-02-25
《脑微出血与急性缺血性卒中的临床关系分析》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、・312・中国神经免疫学和神经病学杂志2016年9月第23卷第5期_ChinJNeuroimmunol&Neurol2016,Vol.23,No.5脑微出血与急性缺血性卒中的临床关系分析滕振杰_董艳红_李玲_贾彩云_肖伊宁_吕佩源__摘要:目的_探讨急性缺血性卒中(AIS)患者脑微出血(CMBs)的危险因素,并进一步探讨CMBs与脑卒中病灶面积和部位的相关性。方法_收集2014‐1-2015‐12在作者医院神经内科住院的AIS患者226例,据是否存在CMBs分为CMBs组(111例)和无CMBs组
2、(115例)。收集研究对象临床资料,采用头颅MRI对其CMBs、脑白质病变(WML)、陈旧腔隙性脑梗死(LI)、AIS病灶面积和部位进行评价,并采用Logistic回归、t检2验、χ检验等分析影响AIS患者发生CMBs的危险因素。结果_多因素Logistic回归分析显示年龄(OR=1.063,95%CI:1.025~1.104,P<0.01)、高血压史(OR=3.488,95%CI:1.113~10.927,P<0.05)、WML(OR=1.282,95%CI:1.155~1.423,P<0.01
3、)及陈旧LI(OR=5.815,95%CI:1.539~21.973,P<0.01)是AIS合并CMBs的独立危险因素;CMBs分级与WML分级(r=0.354,P<0.01)、陈旧LI分级(r=0.394,P<0.01)2均呈正相关;不同脑卒中病灶面积患者间CMBs检出率比较有统计学差异(χ=7.878,P<0.05),其中新发LI2患者更易检出CMBs(χ=6.084,P=0.009<0.017),且CMBs越严重,这种差异越明显(z=-2.832,P=0.005<0.017)。结论_年龄、高
4、血压史、WML及陈旧LI是AIS合并CMBs的独立危险因素,且CMBs严重程度随WML、陈旧LI的严重程度增加而增高。AIS患者CMBs检出率与梗死灶面积有关,在新发LI中更易被发现。关键词:脑微出血;缺血性卒中;核磁共振成像;脑白质病变;腔隙性脑梗死中图分类号:R743.3_文献标识码:A_文章编号:1006‐2963(2016)05‐0312‐06Relationshipbetweencerebralmicrobleedsandacuteischemicstroke__TENGZhenjie,
5、DONGYanhong,LI**Ling,JIACaiyun,XIAOYining,LPeiyuan.GraduateSchoolofHeÜbeiMedicalUniversity;DepartmentofNeurology,HebeiGeneralHospital,Shijiazhuang050051,ChinaCorrespondingauthor:LÜPeiyuan,Email:peiyuanlu@163.comABSTRACT:Objective_Toinvestigatetheriskf
6、actorsofcerebralmicrobleeds(CMBs)inpatientswithacuteischemicstroke(AIS),andexploretherelationshipbetweenCMBsandtheinfarctionlesionareaandlocation.Methods_Atotalof226consecutiveinpatientswithAISfromourdepartmentbetweenJanuary2014toDecember2015werechose
7、ninourstudy.BasedontheoccurrenceofCMBs,thepatientsweredividedintotwogroups(111patientswithCMBs;115patientswithoutCMBs).Thedemographicandclinicaldatawerecollected.MRimagingswereperformedinallthepatients.CMBswereevaluatedaccordingtotheirlocations.Thenum
8、berofoldlacunarinfarcts(LI),theseverityofwhitematterlesions(WML)andtheinfarctionlesion2areaandlocationwerealsorecorded.Multivariatelogisticregressionanalysis,ttestandχtestwereadoptedtoanalyzetheriskfactorsofCMBsinAISpatients.Results_Multivaria
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