Orken D Necioglu, Uysal E, Timer E, Kuloglu-Pazarcı N, Mumcu S, Forta H
Department of Neurology, Sisli Etfal Education and Research Hospital, Istanbul, Turkey.
Clin Neurol Neurosurg. 2013 Sep;115(9):1682-5. doi: 10.1016/j.clineuro.2013.03.004. Epub 2013 Apr 24.
Cerebral microbleeds (CMBs) are known to be indicative of bleeding-prone microangiopathy. Little is known about the significance of CMBs in anticoagulated patients. We determined the frequency of new CMBs in ischemic stroke patients who had been receiving warfarin treatment for 2 years.
A total of 204 ischemic stroke patients on warfarin therapy for 2 years underwent a repeat MRI. We compared demographic features, vascular risk factors, and radiological findings of patients with and without new CMBs.
New CMBs on gradient-echo MRI were found in 29 of 204 patients (10%). Of 35 patients who had CMBs in the original study, 9 developed new CMBs after 2 years (26%), compared with 20 of the 169 patients (12%) who did not have CMBs at baseline (p=0.03). Patients with new CMBs were older than patients without CMBs (p=0.04), and the frequency of leukoaraiosis was significantly higher (p=0.02). The mean duration of warfarin treatment was not significantly different between the patients with and without new CMBs (p=0.28).
This longitudinal study suggested that the presence of CMBs at baseline increased the frequency of new CMBs in patients on warfarin therapy.
脑微出血（CMBs）已知可提示易出血的微血管病变。关于CMBs在接受抗凝治疗患者中的意义，人们了解甚少。我们确定了接受华法林治疗2年的缺血性中风患者中新发CMBs的发生率。
共有204例接受华法林治疗2年的缺血性中风患者接受了重复MRI检查。我们比较了有和没有新发CMBs患者的人口统计学特征、血管危险因素和影像学表现。
204例患者中有29例（10%）在梯度回波MRI上发现新发CMBs。在原始研究中有CMBs的35例患者中，9例（26%）在2年后出现新发CMBs，而基线时无CMBs的169例患者中有20例（12%）出现新发CMBs（p=0.03）。有新发CMBs的患者比无CMBs的患者年龄更大（p=0.04），白质疏松症的发生率显著更高（p=0.02）。有和没有新发CMBs的患者华法林治疗的平均时长无显著差异（p=0.28）。
这项纵向研究表明，基线时存在CMBs会增加接受华法林治疗患者中新发CMBs的发生率。
