Vermeer Sarah E, Koudstaal Peter J, Oudkerk Matthijs, Hofman Albert, Breteler Monique M B
Department of Epidemiology, Erasmus Medical Centre Rotterdam, the Netherlands.
Stroke. 2002 Jan;33(1):21-5. doi: 10.1161/hs0102.101629.
Silent brain infarcts are commonly seen on magnetic resonance imaging (MRI) both in patients with a first stroke and in healthy elderly persons. These infarcts seem associated with an increased risk of stroke. It is unclear whether risk factors for silent infarcts differ from those for symptomatic stroke. We investigated the prevalence of, and cardiovascular risk factors for, silent brain infarcts.
The Rotterdam Scan Study is a population-based cohort study among 1077 participants 60 to 90 years of age. Participants underwent cerebral MRI. We assessed cardiovascular risk factors by interview and physical examination. Associations between risk factors and presence of infarcts were analyzed by logistic regression and adjusted for age, sex, and relevant confounders.
For 259 participants (24%) 1 or more infarcts on MRI were seen; 217 persons had only silent and 42 had symptomatic infarcts. The prevalence odds ratio (OR) of both silent and symptomatic infarcts increased with age by 8% per year (95% CI, 1.06 to 1.10 and 1.04 to 1.13, respectively). Silent infarcts were more frequent in women (age-adjusted OR, 1.4; 95% CI, 1.0 to 1.8). Hypertension was associated with silent infarcts (age- and sex-adjusted OR, 2.4; 95% CI, 1.7 to 3.3), but diabetes mellitus and smoking were not.
Silent brain infarcts are 5 times as prevalent as symptomatic brain infarcts in the general population. Their prevalence increases with age and seems higher in women. Hypertension is associated with silent infarcts, but other cardiovascular risk factors are not.
在首次发生卒中的患者以及健康老年人中，磁共振成像（MRI）检查时常见无症状脑梗死。这些梗死似乎与卒中风险增加相关。目前尚不清楚无症状梗死的危险因素是否与有症状卒中的危险因素不同。我们调查了无症状脑梗死的患病率及其心血管危险因素。
鹿特丹扫描研究是一项针对1077名60至90岁参与者的基于人群的队列研究。参与者接受了脑部MRI检查。我们通过访谈和体格检查评估心血管危险因素。采用逻辑回归分析危险因素与梗死存在之间的关联，并对年龄、性别和相关混杂因素进行校正。
259名参与者（24%）的MRI检查发现1处或多处梗死；217人仅有无症状梗死，42人有症状性梗死。无症状和有症状梗死的患病率比值比（OR）均随年龄增长而增加，每年增加8%（95%CI分别为1.06至1.10和1.04至1.13）。无症状梗死在女性中更为常见（年龄校正OR为1.4；95%CI为1.0至1.8）。高血压与无症状梗死相关（年龄和性别校正OR为2.4；95%CI为1.7至3.3），而糖尿病和吸烟则无此关联。
在普通人群中，无症状脑梗死的患病率是有症状脑梗死的5倍。其患病率随年龄增长而增加，且在女性中似乎更高。高血压与无症状梗死相关，而其他心血管危险因素则无此关联。
