摘要
目的分析高血压脑卒中患者的脑微出血的临床特点,探讨脑微出血的相关危险因素。方法选择丽水市中心医院住院的高血压合并脑卒中患者176例及单纯高血压患者16例,对所有患者均进行梯度回波T2加权成像检查,记录脑微出血病灶数目、部位及患者临床资料。采用Spearman秩相关分析脑微出血严重程度与高血压分级之间的关系,采用多因素Logistic回归分析脑微出血的影响因素。结果高血压患者192例合并脑微出血58例(30.2%),每例出现1～31个不等病灶,其好发部位依次为皮质/皮质下区(37.0%)、基底节(30.7%)、丘脑(14.8%),脑干(11.5%),小脑(6.1%)。脑微出血的严重程度与高血压的严重程度相关(r=0.352,P=0.01)。Logistic回归分析显示脑微出血的发生与年龄(OR=1.062,P=0.008)、收缩压(OR=1.400,P=0.015)相关。结论脑微出血在高血压脑卒中患者中有较高的发生率,以皮质/皮质下区、基底节区多见,脑干、小脑少见。脑微出血的发生与年龄、收缩压密切相关。
Objective To investigate the clinical features and explore the related risk factors of cerebral microbleeds （CMB） in hypertensive patients with stroke. Methods This study involved 176 hypertensive patients with stroke and 16 hypertensive patients without stroke in Lishui Central Hospital between March 2009 and June 2012. The number and location of CMB lesions were documented by assessing gradient recalled echo T2 ＊-weighted imaging （GRE-T2 ＊ WI} and the clinical parameters were recorded. Spearman rank correlation test was used to analyse the correlation between the severity of CMB and hypertension grade-level and multivariate logistic regression was performed to identify the independent risk factors for CMB. Results CMB lesions were observed in 58 （30.2%） of 192 patients, and each of them presented the numbers of CMB from 1 to 31. The distribution of CMB was 37.0% in cortex-subcortex, 30.7% in basal ganglia regions, 14.8% in thalamic, 11.5% in brainstem and 6.1% in cerebellar. Spearman rank correlation provided a statistically significant correlation between the severity of CMB and hyperten- sion grade level（r=0. 352, P=0. 01）. Logistic analysis revealed that CMB was significantly associated with age {OR= 1. 062, P=0. 008） and the systolic blood pressure {OR= 1. 400, P=0.015）. Conclusion CMB had a higher incidence in hypertensive patients with stroke. CMB were more common in cortex-subcortex and basal ganglia, but less in brainstem and cerebellum. Age and systolic blood pressure were significantly associated with CMB.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2013年第3期227-231,共5页
Chinese Journal of Hypertension
基金
卫生部科研基金(WKJ2010-2-022)
关键词
高血压
脑微出血
梯度回波T2加权成像
Hypertension
Cerebral microbleeds
Gradient recalled echo T2 ＊-weighted imaging
