Fanning Jonathon P, Wong Andrew A, Fraser John F
BMC Med. 2014 Jul 9;12:119. doi: 10.1186/s12916-014-0119-0.
Cerebral infarction is a commonly observed radiological finding in the absence of corresponding, clinical symptomatology, the so-called silent brain infarction (SBI). SBIs are a relatively new consideration as improved imaging has facilitated recognition of their occurrence. However, the true incidence, prevalence and risk factors associated with SBI remain controversial.
Systematic searches of the Medline and EMBASE databases from 1946 to December 2013 were performed to identify original studies of population-based adult cohorts derived from community surveys and routine health screening that reported the incidence and prevalence of magnetic resonance imaging (MRI)-determined SBI.
The prevalence of SBI ranges from 5% to 62% with most studies reported in the 10% to 20% range. Longitudinal studies suggest an annual incidence of between 2% and 4%. A strong association was seen to exist between epidemiological estimates of SBI and age of the population assessed. Hypertension, carotid stenosis, chronic kidney disease and metabolic syndrome all showed a strong association with SBI. Heart failure, coronary artery disease, hyperhomocysteinemia and obstructive sleep apnea are also likely of significance. However, any association between SBI and gender, ethnicity, tobacco or alcohol consumption, obesity, dyslipidemia, atrial fibrillation and diabetes mellitus remains unclear.
SBI is a remarkably common phenomenon and endemic among older people. This systematic review supports the association of a number of traditional vascular risk factors, but also highlights disparities between clinically apparent and silent strokes, potentially suggesting important differences in pathophysiology and warranting further investigation.
脑梗死是一种常见的影像学表现，在无相应临床症状时，即所谓的无症状脑梗死（SBI）。随着影像学技术的改进，无症状脑梗死作为一个相对较新的研究对象得到了更多的关注。然而，与无症状脑梗死相关的真实发病率、患病率及危险因素仍存在争议。
对1946年至2013年12月期间的Medline和EMBASE数据库进行系统检索，以确定基于社区调查和常规健康筛查的成人队列的原始研究，这些研究报告了磁共振成像（MRI）确定的无症状脑梗死的发病率和患病率。
无症状脑梗死的患病率在5%至62%之间，大多数研究报告的患病率在10%至20%之间。纵向研究表明，年发病率在2%至4%之间。无症状脑梗死的流行病学估计与所评估人群的年龄之间存在密切关联。高血压、颈动脉狭窄、慢性肾病和代谢综合征均与无症状脑梗死密切相关。心力衰竭、冠状动脉疾病、高同型半胱氨酸血症和阻塞性睡眠呼吸暂停也可能具有重要意义。然而，无症状脑梗死与性别、种族、吸烟或饮酒、肥胖、血脂异常、心房颤动和糖尿病之间的任何关联仍不明确。
无症状脑梗死是一种非常常见的现象，在老年人中普遍存在。本系统评价支持了一些传统血管危险因素之间的关联，但也突出了临床明显卒中与无症状卒中之间的差异，这可能意味着病理生理学上的重要差异，值得进一步研究。
