老年患者脑萎缩的影响因素研究

摘要

Objective To explore the related influencing factors associated with brain atrophy (BA) in elderly patients. Methods The enrolled participants were patients aged ≥ 60 years old who received inpatient treatment in Department of Neurology, Zichuan District Hospital from October 2013 to October 2014. All the patients measured the blood glucose (Glu) , triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) , and based on the measurement results received hypoglycemic and lipid-lowering therapies, as well as underwent brain MRI. The prevalence of BA was assessed in accordance with the brain MRI results. Those with BA and those without were assigned to BA group, and non-BA group, respectively. Baseline characteristics such as gender, age, diagnosis as well as laboratory findings were compared between the two groups. Ordinal logistic regression analysis was carried out to explore the factors associated with BA scores. Results Two groups demonstrated significant differences in the baseline characteristics (P<0.05) (except TG and HDL-C). Ordinal Logistic regression analysis showed that sex〔OR=2.776, 95%CI (1.754, 4.393), P<0.05〕, age〔OR=1.142, 95%CI(1.108, 1.176), P<0.05〕, diagnosis 〔OR=3.717,95%CI(1.570,8.811), P<0.05〕,and levels of LDL-C〔OR=0.510,95%CI (0.304, 0.856), P<0.05〕were the associated factors of BA scores in elderly patients. Conclusion Male, older age, history of ischemic stroke, and decreased LDL-C level may be the independent risk factors for high BA score.%目的 探讨老年患者脑萎缩(BA)的相关影响因素.方法 2013年10月—2014年10月选取淄博市淄川区医院神经内科收治的≥60岁的老年患者为研究对象.患者入院接受降糖、降脂药物治疗前检测血糖(Glu)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,同时进行颅脑MRI检查并根据检查结果进行BA评分.依据BA评分结果将入选患者分为无BA组(n=131)和BA组(n=200),比较两组患者的一般资料(性别、年龄、诊断)及实验室检查指标,并采用有序Logistic回归分析分析BA评分的影响因素.结果 除TG和HDL-C外,无BA组和BA组患者一般资料及其他实验室检查指标比较,差异均有统计学意义(P<0.05).有序Logistic回归分析结果显示,性别〔OR=2.776,95%CI(1.754,4.393),P<0.05〕、年龄〔OR=1.142,95%CI(1.108,1.176),P<0.05〕、诊 断〔OR=3.717,95%CI(1.570,8.811),P<0.05〕、LDL-C水平〔OR=0.510,95%CI(0.304,0.856),P<0.05〕是老年患者BA评分的影响因素.结论 男性、高龄、缺血性卒中和低LDL-C水平可能是老年患者BA评分加重的危险因素.