短暂后循环缺血患者脑白质变性严重程度的相关因素分析

摘要

目的：分析短暂后循环缺血（ PCI）患者脑白质变性（ LA）严重程度的独立相关因素。方法连续选取313例短暂PCI患者，根据Wahlund改良LA分级量表（ ARWMC）评分对LA严重程度的分级进行分组，记录各临床资料；对各计量资料与ARWMC评分进行Spearman相关分析，对各计数资料与ARWMC评分进行Kendall相关分析；对有统计意义的变量，进行有序多分类Logistic回归分析。结果各临床资料与LA得分的相关分析筛选结果显示，年龄、性别、心电图RV5＋SV2、颈动脉斑块、CRP、HDL、Hcy、叶酸与短暂PCI患者LA严重程度相关（ P均＜0．1）；Logistic回归分析结果显示，未发现心电图RV5＋SV2、CRP、Hcy、性别与短暂PCI患者LA严重程度的独立相关性（P均＞0．05）；而年龄（P＝0．000，OR＝1．119，95％CI：1．089～1．149）、HDL（P＝0．042，OR＝0．390，95％ CI：0．157～0．967）、叶酸（P＝0．006，OR＝0．914，95％ CI：0．856～0．974）、颈动脉斑块形成（P＝0．000，OR＝5．023，95％CI：2．672～9．440）与短暂PCI患者LA严重程度独立相关（P均＜0．05）。结论年龄、有无颈动脉斑块及HDL、叶酸水平是短暂PCI患者LA严重程度的独立相关因素。%Objective To explore the independent predictive factors of severity of leukoaraiosis ( LA) in transient posterior circulation ischemia ( PCI) patients.Methods To select 313 consecutive PCI in patients with MRI images retro-spectively, gathering their age, gender, ECG ( RV5 +SV2 ) , plaques shown in carotid ultrasound, CRP, Cholesterol, HDL, Hcy, triglycerides, LDL, UA, HbA1C , folic acid, VB12 .The severity of LA was evaluated by ARWMC scale.Cor-relation analysis and ordinal logistic regression were analyzed with SPSS16.0 software.Results Age, gender, ECG ( RV5+SV2 ) , carotid plaque, CRP, HDL, Hcy, folic acid were screened out with correlation analysis ( all P<0.1);the ordi-nal logistic regression indicated that age, HDL, folic acid carotid plaque were independent predictive factors of severity of LA in transient PCI patients (all P<0.05).Conclusion Age, HDL, folic acid, carotid plaque are independent predic-tive factors of severity of LA in transient PCI patients.