皮层下脑梗死病变与轻度认知障碍及供血动脉狭窄的关联分析

摘要

目的：就皮层下脑梗死病变、轻度认知障碍，及供血动脉狭窄三者之间的相互的关联展开初步分析。方法本研究中纳入分析的685例近年来天津市第五中心医院院神经内科就诊的皮层下梗死病变患者，分析皮层下梗死患者中认知障碍构成情况以及供血动脉狭窄状况，并分析三者之间的相互关联。结果本研究中皮层下梗死病变患者中轻度意识障碍者占9.20％；供血血管狭窄病例占49.34％。供血血管狭窄者发生皮层下梗死并轻度意识障碍的概率为非狭窄者的2.138倍，比值比（ odds ratio ， OR ＝2.138）；年龄大于70岁、皮层下梗死病程长、饮酒史和痴呆家族史也都与皮层下梗死并轻度意识障碍呈现正向关联；多因素回归分析结果还提示高血压以及脑血管病家族史也是危险因素。此外，轻度认知障碍能使皮层下梗死并供血血管狭窄的发生概率增高，OR值为2.077；年龄大于70岁、皮层下梗死病程长、高血压以及脑血管病家族史均为皮层下梗死并供血血管狭窄的危险因素；多因素回归分析结果中，轻度认知障碍、皮层下梗死病程长、超重肥胖以及高血压均为皮层下梗死并供血血管狭窄发生的危险因素。结论供血动脉狭窄与皮层下梗死并发轻度认知障碍的发生呈正相关关系，同时轻度认知障碍的存在又与皮层下梗死并供血动脉狭窄的风险增加存在关联，三者之间相互关联，同时年龄、皮层下梗死病程以及相关家族史等因素也潜在影响三者之间关系。%Objective To investigate the association among cerebral lesions, mild cognitive impairment and artery stenosis.Methods In 685 cases which seek medical care in our hospital in recent years, we studied the cortical infarction lesions in this study, analysis of subcortical infarction in patients with cognitive impairment as well as the composition of the artery stenosis conditions were conducted .Results in this study, subcortical infarct patients with mild disturbance of consciousness accounted for 9.20%, while blood supply stenosis cases accounted for 49.34%.Elder than 70 years, long course of subcortical infarction, family history of alcohol consumption and dementia were associated with cortical (P <0.05), the incidence of subcortical infarct and mild cognitive disturbance were 2.138 times for infarct and mild disturbance of consciousness patients.Multivariate regression analysis showed that family history of hypertension and cerebrovascular disease were also risk factors.In addition, mild cognitive impairment can increase the risk of subcortical infarct and the incidence of vascular stenosis, OR was 2.077;elder than 70 years of age, subcortical infarct length, hypertension and family history of cerebrovascular disease were risk factors for subcortical infarction and stenosis of blood supply.In multivariate regression analysis, mild cognitive impairment, long duration of subcortical infarct, overweight and obesity, and hypertension showed to be risk factors of subcortical infarct and blood supply stenosis.Conclusion The artery stenosis and subcortical infarction with mild cognitive impairment show a positive correlation, while the presence of mild cognitive impairment and subcortical infarction and artery stenosis and an increased risk of an association, are related to each while age, duration and associated subcortical infarcts family history and other factors also affect the potential relationship between them .