Liang Changhu, Wang Jing, Feng Mengmeng, Zhang Nan, Guo Lingfei
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Quant Imaging Med Surg. 2022 Jan;12(1):119-130. doi: 10.21037/qims-21-28.
We aimed to investigate risk factors for the presence and number of cerebral microbleeds (CMBs) in patients with different stages of hypertension stages, with an emphasis on the relationship between white matter changes (WMCs) and CMBs.
Since 2016, participants aged 40 years or more have been evaluated for the presence of CMBs using enhanced 3D multiecho GE T2*-weighted angiography (ESWAN) sequences. The Mann-Whitney U test and Pearson χ test were used to compare the clinical characteristics between the CMB and no-CMB patient groups. Furthermore, we used Spearman's rank correlation analysis to examine the associations between the degree of CMB severity and other important factors.
CMBs were detected in 110 (36.7%) of 300 participants. Among patients with stage 2 hypertension, the majority also had CMBs (61.8%, 68/110). CMBs were positively correlated with age, hypertension stage, duration of hypertension, WMCs, and silent cerebral infarction. Patients with grade 3 WMCs were significantly more likely to have CMBs than those without WMCs; this association was true for both patients with stage 1 and those with stage 2 hypertension. In patients with stage 1 or stage 2 hypertension lasting longer than 20 years, the majority had CMBs (69.0%, 29/42; 69.1%, 47/68). The results of binary logistic regression indicated that a more severe hypertension stage, longer duration of hypertension, aging, having silent cerebral infarction and higher values of WMC increase the likelihood of the occurrence of CMBs.
CMBs detected in hypertensive patients were more likely to occur in deep structures, and the grade of WMCs and duration of hypertension were more closely associated with the CMB degree than with age.
我们旨在研究不同高血压阶段患者脑微出血（CMB）的存在及数量的危险因素，重点关注白质病变（WMC）与CMB之间的关系。
自2016年以来，对40岁及以上的参与者使用增强型3D多回波GE T2*加权血管造影（ESWAN）序列评估CMB的存在情况。采用Mann-Whitney U检验和Pearson χ检验比较CMB患者组和无CMB患者组的临床特征。此外，我们使用Spearman等级相关分析来检验CMB严重程度与其他重要因素之间的关联。
300名参与者中有110名（36.7%）检测到CMB。在2级高血压患者中，大多数也有CMB（61.8%，68/110）。CMB与年龄、高血压阶段、高血压病程、WMC和无症状性脑梗死呈正相关。3级WMC患者比无WMC患者更易发生CMB；1级高血压患者和2级高血压患者均如此。在病程超过20年的1级或2级高血压患者中，大多数有CMB（69.0%，29/42；69.1%，47/68）。二元逻辑回归结果表明，高血压阶段更严重、高血压病程更长、年龄增长、有无症状性脑梗死以及WMC值更高会增加CMB发生的可能性。
高血压患者中检测到的CMB更易发生于深部结构，WMC等级和高血压病程与CMB程度的相关性比年龄更密切。
