Zheng Kai, Wang Zheng, Chen Xi, Chen Jiajie, Fu Yu, Chen Qin
Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China.
Brain Sci. 2023 May 22;13(5):835. doi: 10.3390/brainsci13050835.
White matter hyperintensity (WMH) is prevalent in older adults aged 60 and above. A large proportion of people with WMH have not experienced stroke and little has been reported in the literature.
The case data of patients aged ≥60 years without stroke in Wuhan Tongji Hospital from January 2015 to December 2019 were retrospectively analyzed. It was a cross-sectional study. Univariate analysis and logistic regression were used to analyze independent risk factors for WMH. The severity of WMH was assessed using the Fazekas scores. The participants with WMH were divided into periventricular white matter hyperintensity (PWMH) group and deep white matter hyperintensity (DWMH) group, then the risk factors of WMH severity were explored separately.
Eventually, 655 patients were included; among the patients, 574 (87.6%) were diagnosed with WMH. Binary logistic regression showed that age and hypertension were associated with the prevalence of WMH. Ordinal logistic regression showed that age, homocysteine, and proteinuria were associated with the severity of WMH. Age and proteinuria were associated with the severity of PWMH. Age and proteinuria were associated with the severity of DWMH.
The present study showed that in patients aged ≥60 years without stroke, age and hypertension were independent risk factors for the prevalence of WMH; while the increasing of age, homocysteine, and proteinuria were associated with greater WMH burden.
脑白质高信号(WMH)在60岁及以上的老年人中普遍存在。很大一部分有WMH的人未曾经历过中风,且文献报道较少。
回顾性分析2015年1月至2019年12月在武汉同济医院年龄≥60岁且无中风的患者的病例数据。这是一项横断面研究。采用单因素分析和逻辑回归分析WMH的独立危险因素。使用Fazekas评分评估WMH的严重程度。将有WMH的参与者分为脑室周围白质高信号(PWMH)组和深部白质高信号(DWMH)组,然后分别探讨WMH严重程度的危险因素。
最终纳入655例患者;其中574例(87.6%)被诊断为WMH。二元逻辑回归显示年龄和高血压与WMH的患病率相关。有序逻辑回归显示年龄、同型半胱氨酸和蛋白尿与WMH的严重程度相关。年龄和蛋白尿与PWMH的严重程度相关。年龄和蛋白尿与DWMH的严重程度相关。
本研究表明,在年龄≥60岁且无中风的患者中,年龄和高血压是WMH患病率的独立危险因素;而年龄、同型半胱氨酸和蛋白尿的增加与更大的WMH负担相关。