Thein S S, Hamidon B B, Teh H S, Raymond A A
Neurology Unit, Department of Medicine, Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
Singapore Med J. 2007 May;48(5):396-9.
Leukoaraiosis (LA) is a term that defines an abnormal appearance of the subcortical white matter of the brain on neuroimaging. This study was done to evaluate the predictive value of LA in terms of mortality, disability and cognitive decline at three months post-stroke and also to identify the risk factors that are independently associated with LA in a stroke population.
This was a prospective observational study of all patients with acute ischaemic stroke who were admitted to Hospital Universiti Kebangsaan Malaysia from June to November 2004. A single observer using the pre-defined diagnostic criteria recorded the information on demography, Barthel Index and mini-mental state examination. LA was diagnosed on brain computed tomography alone.
60 patients were recruited into the study. Three patients (five percent) died and LA was present in 29 patients (48 percent). There was no significant association between LA and mortality (p-value equals 0.89). The independent risk factors that were associated with LA were age (odds-ratio [OR] 4.43; 95 percent confidence interval [CI] 1.28-15.27) and hypertension (OR 14.3; 95 percent CI 1.40-147.42). There was a significant association between LA with early dementia (OR 3.53; 95 percent CI 1.19-10.49). However, LA did not significantly predict any functional disability (Barthel Index is less than 60) in the study population (p-value equals 0.45).
Development of LA correlates significantly with ageing and hypertension. The presence of LA can also predict early cognitive dysfunction but is not associated with functional disability at three months post-stroke.
脑白质疏松（LA）是一个用于定义神经影像学上大脑皮质下白质异常表现的术语。本研究旨在评估LA对卒中后三个月死亡率、残疾率和认知功能下降的预测价值，并确定卒中人群中与LA独立相关的危险因素。
这是一项对2004年6月至11月入住马来西亚国立大学医院的所有急性缺血性卒中患者进行的前瞻性观察研究。一名观察者使用预先定义的诊断标准记录人口统计学、巴氏指数和简易精神状态检查的信息。仅通过脑部计算机断层扫描诊断LA。
60名患者被纳入研究。3名患者（5%）死亡，29名患者（48%）存在LA。LA与死亡率之间无显著关联（p值等于0.89）。与LA相关的独立危险因素是年龄（比值比[OR]4.43；95%置信区间[CI]1.28 - 15.27）和高血压（OR 14.3；95%CI 1.40 - 147.42）。LA与早期痴呆之间存在显著关联（OR 3.53；95%CI 1.19 - 10.49）。然而，在研究人群中，LA并未显著预测任何功能残疾（巴氏指数小于60）（p值等于0.45）。
LA的发生与衰老和高血压显著相关。LA的存在还可预测早期认知功能障碍，但与卒中后三个月的功能残疾无关。
