Tanaka H, Sueyoshi K, Nishino M, Ishida M, Fukunaga R, Abe H
First Department of Internal Medicine, Osaka Rosai Hospital, Japan.
Arch Neurol. 1993 Jul;50(7):706-9. doi: 10.1001/archneur.1993.00540070026009.
Silent brain infarction is fairly common in the elderly, but predictive factors have not been definitively established. This study focuses attention on ischemic heart disease and cerebrovascular risk factors about the frequency of silent brain infarction.
The existence of silent brain infarction, the extent of coronary artery stenosis, and cerebrovascular risk factors of consecutive 92 case series with suspected ischemic heart disease were surveyed.
A hospital for patients with ischemic heart disease.
Ninety-two consecutive Japanese patients with suspected ischemic heart disease were recruited.
All subjects were evaluated for coronary atherosclerosis (number of coronary arteries with significant stenosis and Gensini score), the number of silent brain infarctions detected by computed tomography, the extent of carotid atherosclerosis as determined by B-mode ultrasonography, and cerebrovascular risk factors.
Patients with silent cerebral infarctions were older (66.2 +/- 10.4 years) than those without such events (60.1 +/- 8.8 years) (P < .01). The extent of coronary atherosclerosis in patients with silent cerebral infarctions was significantly greater than in those without such events after adjustment for the effect of age (P < .001). The extent of carotid atherosclerosis and the percentages of individuals with hypertension, diabetes mellitus, a smoking habit, hypercholesterolemia, hypertriglyceridemia, and a low serum high-density lipoprotein cholesterol level did not differ between the groups with and without silent brain infarction. The frequency of silent brain infarction increased with the severity of coronary stenosis.
Coronary atherosclerosis and age were important risk factors for silent brain infarction.
无症状性脑梗死在老年人中相当常见，但预测因素尚未明确确立。本研究关注缺血性心脏病和脑血管危险因素与无症状性脑梗死发生频率的关系。
对连续92例疑似缺血性心脏病患者的无症状性脑梗死情况、冠状动脉狭窄程度及脑血管危险因素进行调查。
一家收治缺血性心脏病患者的医院。
招募了连续92例疑似缺血性心脏病的日本患者。
对所有受试者评估冠状动脉粥样硬化情况（有显著狭窄的冠状动脉数量及Gensini评分）、计算机断层扫描检测到的无症状性脑梗死数量、B型超声确定的颈动脉粥样硬化程度以及脑血管危险因素。
有无症状性脑梗死的患者年龄更大（66.2±10.4岁），高于无此类情况的患者（60.1±8.8岁）（P<.01）。在调整年龄影响后，有无症状性脑梗死的患者冠状动脉粥样硬化程度显著高于无此类情况的患者（P<.001）。有无症状性脑梗死的两组之间，颈动脉粥样硬化程度以及高血压、糖尿病、吸烟习惯、高胆固醇血症、高甘油三酯血症和血清高密度脂蛋白胆固醇水平低的个体百分比无差异。无症状性脑梗死的发生频率随冠状动脉狭窄严重程度增加而升高。
冠状动脉粥样硬化和年龄是无症状性脑梗死的重要危险因素。
