脑白质疏松症严重程度与其发生的相关因素分析

摘要

目的 评价脑白质疏松症(LA)临床相关危险因素之间的相关性及预测病情的价值.方法 回顾性调查行头颅MRI检查的住院患者218例,根据诊断分为非LA 56例和LA 162例,LA患者又根据Fazekas等级分类标准,分为轻度LA 52例,中度LA 53例及重度LA 57例.对相关危险因素(年龄、性别、既往疾病、血脂等)分别进行逐个单因素和多因素logistic回归分析.结果 TC、高LDL-C、高同型半胱氨酸与轻度LA发生有相关性(P＜0.05,P＜0.01).年龄≥70岁、高血压3级、吸烟、高TC,高同型半胱氨酸与中度LA的发生有相关性(P＜0.05,P＜0.01).年龄≥70岁、高血压3级、高LDL-C、高同型半胱氨酸、颈动脉内膜中层厚度增厚与重度LA的发生有相关性(P＜0.05).结论 年龄≥70岁、高血压3级、高同型半胱氨酸、高TC、高LDL-C、吸烟及颈动脉内膜中层厚度增厚是LA的独立发病危险因素.中度LA和重度LA与年龄≥70岁、高血压3级及颈动脉内膜中层厚度增厚有明显相关性.%Objective To assess the correlation between leukoaraiosis(LA)-related risk factors and its value in predicting the condition of LA. Methods Two hundred and eighteen patients admitted to our hospital for cranial MRI were divided into non-LA group(n = 56) and LA group(n=162). Patients in LA group were further divided into mild LA group(n = 52) ,moderate LA group(n = 53),and severe LA group(n=57) according to the Fazekas classification. Their relative risk fac- tors,including age,gender,history of disease,and blood-lipid,were analyzed by single and multi-factorial logistic regression analysis. Results The TC,LDL-C and high homocysteine were related with mild LA(P<0. 05,P<0. 01). Age ≥70 years, hypertension grade 3,smoking,high cholesterol and high homocysteine were related with moderate LA(P<0. 05,P<0. 01). Age ≥70 years,hypertension grade 3,LDL-C,high homocysteine and carotid intima-media thickness were related with severe LA(P<0. 05,P<0. 01). Conclusion Age ≥70 years,hypertension grade 3, high homocysteine,TC, LDL-C and carotid intima-media thickness are the independent risk factors for LA. Moderate and severe LA are closely related with age ≥70 years,hypertension grade 3 and carotid intima-media thickness.