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严格局限于深部或脑叶区域的脑微出血的危险因素有所不同。

Risk factors of cerebral microbleeds in strictly deep or lobar brain regions differed.

作者信息

Zhang Changqing, Li Zixiao, Wang Yilong, Zhao Xingquan, Wang Chunxue, Liu Liping, Pu Yuehua, Zou Xinying, Pan Yuesong, Du Wanliang, Jing Jing, Wang Dongxue, Luo Yang, Wong Ka Sing, Wang Yongjun

机构信息

Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.

Department of Nephrology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.

出版信息

J Stroke Cerebrovasc Dis. 2015 Jan;24(1):24-30. doi: 10.1016/j.jstrokecerebrovasdis.2014.07.041. Epub 2014 Oct 16.

Abstract

BACKGROUND

T2*-weighted gradient echo magnetic resonance imaging is sensitive in detecting cerebral microbleeds (MBs), but there are few reports on the risk factors of MBs in different brain regions. Therefore, we aimed to investigate whether the risk factors associated with the presence of MBs in strictly deep or lobar brain regions were different.

METHODS

This study consisted of 696 consecutive acute ischemic stroke patients from 6 hospitals in the Chinese IntraCranial AtheroSclerosis Study. We evaluated the number and location of MBs, severity of lacune and leukoaraiosis (LA), and etiologic subtype of ischemic stroke. Multivariable logistic regression was used to analyze risk factors of MBs in different brain regions.

RESULTS

Among 696 acute ischemic stroke patients, 162 patients (23.3%) had MBs. Of them, 62 patients had strictly deep brain MBs, 49 patients had strictly lobar MBs. There was a significant correlation between the number of MBs, the number of lacune, and the severity of LA (P < .0001). In multivariable logistic regression analysis, both strictly deep and strictly lobar brain, MBs were significantly associated with history of cerebral hemorrhage (P = .037 and P = .026, respectively), presence of lacune (P = .004 and P = .032, respectively), and severe LA (P = .002 and P = .008, respectively). However, MBs in strictly deep regions were significantly associated with higher mean arterial pressure (P = .030), and those in strictly lobar brain regions were significantly associated with older age (P = .023).

CONCLUSIONS

The risk factors of MBs in strictly deep or lobar regions differ modestly, which may be related to heterogeneous vascular pathologic changes.

摘要

背景

T2*加权梯度回波磁共振成像在检测脑微出血(MBs)方面很敏感,但关于不同脑区MBs危险因素的报道较少。因此,我们旨在研究与严格深部或脑叶脑区MBs存在相关的危险因素是否不同。

方法

本研究纳入了中国颅内动脉粥样硬化研究中6家医院的696例连续急性缺血性卒中患者。我们评估了MBs的数量和位置、腔隙和白质疏松(LA)的严重程度以及缺血性卒中的病因亚型。采用多变量逻辑回归分析不同脑区MBs的危险因素。

结果

在696例急性缺血性卒中患者中,162例(23.3%)有MBs。其中,62例有严格深部脑MBs,49例有严格脑叶MBs。MBs数量、腔隙数量和LA严重程度之间存在显著相关性(P <.0001)。在多变量逻辑回归分析中,严格深部和严格脑叶脑区的MBs均与脑出血病史显著相关(分别为P =.037和P =.026)、腔隙存在(分别为P =.004和P =.032)以及严重LA(分别为P =.002和P =.008)。然而,严格深部区域的MBs与较高的平均动脉压显著相关(P =.030),而严格脑叶脑区的MBs与年龄较大显著相关(P =.023)。

结论

严格深部或脑叶区域MBs的危险因素略有不同,这可能与异质性血管病理变化有关。

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