Le Pira F, Giuffrida S, Giammona G, Saponara R, Lanza S, La Spina V
Istituto di Scienze Neurologiche, Università degli Studi di Catania.
Ann Ital Med Int. 1997 Apr-Jun;12(2):72-5.
To assess the role that age and some vascular risk factors play in the pathogenesis of leukoaraiosis and lacunar infarcts in patients with ischemic stroke, we examined 71 consecutive patients who had undergone magnetic resonance imaging because of clinical suspicion of stroke. We collected data regarding hypertension, diabetes mellitus, cardiac diseases, hypercholesterolemia, and hematocrit, and compared patients with lacunar infarcts to those with cortical or subcortical nonlacunar lesions. Patients were then assigned to one of two age groups, Group A (< or = 66 years), or Group B (> 66 years). We found a significant correlation between the presence and severity of leukoaraiosis and the presence of lacunar infarcts in both groups. In Group A, however, lacunar infarcts were correlated to hematocrit, while in Group B they were correlated to a trend to hypertension. Leukoaraiosis was correlated to hypertension only in Group A. Although we noted a strong correlation between leukoaraiosis and lacunar infarcts suggesting a common small-vessel disease, our data indicate that different pathogenetic mechanisms are involved. We suggest that patients be grouped according to age in future studies on the role that risk factors play in the pathogenesis of leukoaraiosis and lacunar infarcts.
为评估年龄和一些血管危险因素在缺血性中风患者脑白质疏松症和腔隙性梗死发病机制中的作用，我们检查了71例因临床怀疑中风而接受磁共振成像检查的连续患者。我们收集了有关高血压、糖尿病、心脏病、高胆固醇血症和血细胞比容的数据，并将腔隙性梗死患者与皮质或皮质下非腔隙性病变患者进行了比较。然后将患者分为两个年龄组之一，A组（≤66岁）或B组（>66岁）。我们发现两组中脑白质疏松症的存在和严重程度与腔隙性梗死的存在之间存在显著相关性。然而，在A组中，腔隙性梗死与血细胞比容相关，而在B组中，它们与高血压趋势相关。仅在A组中，脑白质疏松症与高血压相关。尽管我们注意到脑白质疏松症与腔隙性梗死之间存在很强的相关性，提示存在共同的小血管疾病，但我们的数据表明涉及不同的发病机制。我们建议在未来关于危险因素在脑白质疏松症和腔隙性梗死发病机制中作用的研究中，应根据年龄对患者进行分组。
