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小血管疾病中单一和多个症状性病变的危险因素是否存在差异?一与多之间的差异是什么——来自201例塞尔维亚患者的经验。

Is there a difference in risk factors for single and multiple symptomatic lesions in small vessel disease? What is the difference between one and plenty--experience from 201 Serbian patients.

作者信息

Pavlovic Aleksandra M, Pekmezovic Tatjana, Zidverc-Trajkovic Jasna, Pavlovic Dragan M, Jovanovic Zaga, Mijajlovic Milija, Petrovic Mirjana, Kostic Vladimir S, Sternic Nadezda

机构信息

Institute of Neurology, Clinical Center of Serbia, Dr. Subotica 6, 11000 Belgrade, Serbia.

出版信息

Clin Neurol Neurosurg. 2006 Jun;108(4):358-62. doi: 10.1016/j.clineuro.2005.03.009.

Abstract

OBJECTIVES/PURPOSES: Small vessel disease (SVD) is associated with traditional vascular risk factors (RF). The aim of our study was to determine whether different SVD types, single lacunar infarction (LI) and multiple LI (MLI) with or without white matter lesions (WML), have different RF profiles.

PATIENTS AND METHODS

Forty RF parameters were analysed in 201 consecutive patients with magnetic resonance imaging finding of SVD.

RESULTS

History of arterial hypertension, higher systolic and mean blood pressure (BP) but also hypotension, and higher plasma homocysteine levels were more frequent in MLI compared to single LI patients (p<0.05). Patients with one LI were younger, more frequently had clinically evident stroke and family history of cardiovascular disease (CVD) (p<0.05). Significant difference between groups was found only in these RF, indicating that similar pathological processes led to both types of SVD.

CONCLUSION

Positive correlation with age and family history of CVD necessitates further analyses of other factors, predominantly genetic, as the key to the answer why patients develop different lesions in SVD.

摘要

目的

小血管疾病(SVD)与传统血管危险因素(RF)相关。我们研究的目的是确定不同类型的SVD,即单发腔隙性梗死(LI)和伴有或不伴有白质病变(WML)的多发LI,是否具有不同的RF特征。

患者与方法

对201例经磁共振成像检查发现患有SVD的患者的40项RF参数进行了分析。

结果

与单发LI患者相比,多发LI患者中动脉高血压病史、较高的收缩压和平均血压(BP)以及低血压、较高的血浆同型半胱氨酸水平更为常见(p<0.05)。单发LI患者更年轻,临床上明显中风和心血管疾病(CVD)家族史的发生率更高(p<0.05)。仅在这些RF中发现组间存在显著差异,这表明相似的病理过程导致了两种类型的SVD。

结论

与年龄和CVD家族史呈正相关,这就需要进一步分析其他因素,主要是基因因素,以找到患者在SVD中出现不同病变的关键答案。

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