Objective To investigate the relationship between plasma endothelial microparticle level and cerebral microbleeds in patients with lacunar infarction. Methods A total of 90 patients with lacunar infarction were selected in the People′s Hospital of Shiyan Affiliated to Hubei Medical College from June 2013 to March 2015,incidence of cerebral microbleeds and plasma endothelial microparticle level were compared in patients with different clinical features,and the influencing factors of cerebral microbleeds were analyzed. Results The incidence of cerebral microbleeds of lacunar infarction patients equal or over 65 years old,complicated with hypertension,complicated with coronary heart disease,with smoking,with LDL equal or over 3. 37 mmol/ L,with HDL below 1. 25 mmol/ L was statistically significantly higher than that of patients below 65 years old,did not complicated with hypertension,did not complicated with coronary heart disease,without smoking,with LDL below 3. 37 mmol/ L,with HDL equal or over 1. 25 mmol/ L,respectively( P < 0. 05);while no statistically significant differences of incidence of cerebral microbleeds was found in lacunar infarction patients with different gender,complicated with diabetes or not or with different TG(P > 0. 05). Plasma endothelial microparticle level of lacunar infarction patients equal or over 65 years old, complicated with hypertension,complicated with diabetes,complicated with coronary heart disease,with smoking,with LDL equal or over 3. 37 mmol/ L,with HDL below 1. 25 mmol/ L,complicated with cerebral microbleeds was statistically significantly higher than that of patients below 65 years old,did not complicated with hypertension,did not complicated with diabetes,did not complicated with coronary heart disease,without smoking,with LDL below 3. 37 mmol/ L,with HDL equal or over 1. 25 mmol/ L,did not complicated with cerebral microbleeds,respectively(P < 0. 05);while no statistically significant differences of plasma endothelial microparticle level was found in lacunar infarction patients with different gender or with different TG(P >0. 05). Multivariate logistic regression analysis showed that,age〔 OR = 5. 165,95% CI(1. 474,18. 102)〕,hypertension〔OR = 6. 417,95% CI(2. 307,17. 850)〕,coronary heart disease〔 OR = 3. 554,95% CI(1. 065,11. 858)〕,smoking〔OR = 3. 881,95% CI(1. 202,12. 528)〕 and plasma endothelial microparticle level〔 OR = 10. 859,95% CI(2. 975, 41. 018)〕were risk factors of cerebral microbleeds in patients with lacunar infarction,while HDL〔 OR = 0. 106,95% CI (0. 016,0. 696)〕was the protective factor(P < 0. 05). Conclusion Elevated plasma endothelial microparticle level is one of the risk factors of cerebral microbleeds in patients with lacunar infarction,it plays an important role in predicting the incidence of cerebral microbleeds in patients with lacunar infarction.%目的：探讨血浆内皮微粒（EMP）水平与腔隙性脑梗死患者脑微出血（ CMB）的关系。方法选取2013年6月—2015年3月在湖北医药学院附属十堰市人民医院接受治疗的腔隙性脑梗死患者90例。比较不同临床特征的腔隙性脑梗死患者 CMB 发生率和血浆 EMP 水平，并分析腔隙性梗死患者 CMB 的影响因素。结果年龄≥65岁、合并高血压、合并冠心病、吸烟、低密度脂蛋白（LDL）≥3.37 mmol/ L 和高密度脂蛋白（HDL）<1.25 mmol/ L 的腔隙性脑梗死患者 CMB 发生率分别高于年龄<65岁、未合并高血压、未合并冠心病、不吸烟、LDL <3.37 mmol/ L 和HDL≥1.25 mmol/ L 的腔隙性脑梗死患者（P <0.05）；不同性别、是否合并糖尿病、不同三酰甘油（TG）水平的腔隙性脑梗死患者 CMB 发生率比较，差异无统计学意义（P >0.05）。年龄≥65岁、合并高血压、合并糖尿病、合并冠心病、吸烟、LDL≥3.37 mmol/ L、HDL <1.25 mmol/ L 及合并 CMB 的腔隙性脑梗死患者血浆 EMP 水平分别高于年龄<65岁、未合并高血压、未合并糖尿病、未合并冠心病、不吸烟、LDL <3.37 mmol/ L、HDL≥1.25 mmol/ L 及未合并 CMB的腔隙性脑梗死患者（P <0.05）；不同性别、不同 TG 水平的腔隙性脑梗死患者血浆 EMP 水平比较，差异无统计学意义（P >0.05）。多因素 logistic 回归分析结果显示，年龄〔 OR =5.165，95% CI（1.474，18.102）〕、高血压〔 OR=6.417，95% CI（2.307，17.850）〕、冠心病〔OR =3.554，95% CI（1.065，11.858）〕、吸烟〔OR =3.881，95% CI （1.202，12.528）〕和血浆 EMP 水平〔OR =10.859，95% CI（2.975，41.018）〕是腔隙性脑梗死患者 CMB 的危险因素，HDL 是腔隙性脑梗死患者 CMB 的保护因素〔 OR =0.106，95% CI（0.016，0.696）〕（ P <0.05）。结论血浆EMP 水平升高是腔隙性脑梗死患者 CMB 的危险因素，其可作为腔隙性脑梗死患者 CMB 的预测指标。
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