Risk factors for the occurrence and development of Binswanger disease: A controlled observation

摘要

BACKGROUND: Some scholars think that hypertension is the major risk factor to cause Binswanger disease (BD), however, BD is also found in some persons with normal blood pressure, so we presume that some other factors, such as diabetes mellitus, hyperlipemia, coronary heart disease and transient ischemic attacks and so on, might participant in the onset of BD. OBJECTIVE: To comparatively observe the difference in accompanying diseases, transcranial doppler (TCD) performance, blood glucose and blood lipid level between BD patients and healthy subjects who received health examination, and between BD patients with different disease condition. DESIGN: Case-control analysis. SETTING: Department of Emergency, Qingdao Municipal Hospital. PARTICIPANTS: Totally 126 patients with BD, 65 male and 61 female, aged from 67 to 85 years old, who hospitalized in the Medical School Hospital of Qingdao University and Qingdao Municipal People’s Hospital, were chosen, serving as BD patients group. All the patients met the clinical diagnostic criteria of BD introduced by Bennett et al. Another 126 persons, 65 male and 61 female, aged ranging from 67 to 80 years, who received health examination in the same hospital, were homeochronously chosen, serving as control group. Informed consents were obtained from all the subjects. METHODS: After being admitted, all the subjects including BD patients and persons who homeochronously received health examination in the same hospital were given examinations of blood pressure, blood lipid, blood glucose, electrocardiogram (ECG) and TCD. Fifty-seven patients with BD were in the stable period and 69 in the progressive period (Stable period: no local or subcortical function disorder found, and no changes in the range of white matter lesion showed by CT and/or MRI in recent 3 months; Progressive period: with local or subcortical function disorder and increase in the range of white matter lesion showed by CT and/or MRI in recent 3 months). According to intimal thickening of carotid artery and vertebral artery preformed by TCD, BD was graded as mild intimal thickening ( 1.2 mm). MAIN OUTCOME MEASURES: Comparison of the ratio of BD patients with accompanied diabetes mellitus, hyperlipemia, coronary heart disease and transient ischemic attacks, TCD performance, blood glucose and blood lipid level between BD patients group and control group, and among BD patients with various disease conditions. RESULTS: Totally 126 BD patients and 126 subjects who received health examination all participated in the result analysis. Intergroup comparison: ①The ratio of BD patients with accompanied hypertension, diabetes mellitus, hyperlipemia, transient ischemic attacks and coronary heart disease was 91.3%, 46.8%, 42.9%, 81.7% and 46.0% respectively in the BD patients group, and that was 36.5%, 17.5%, 15.9%, 34.1% and 34.1%, respectively in the control group. Significant difference existed between two groups (χ2=86.201,24.907,25.660,58.620,9.900, P 0.05). CONCLUSION: Hypertension, cerebral arteriosclerosis, diabetes mellitus, hyperlipemia, coronary heart disease and transient ischemic attacks have important effects on the onset of BD; Transient ischemic attacks and coronary heart disease can worsen the symptoms of BD patients.