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目的探讨脑梗死患者脑白质病变(white matter lesions,WML)患病情况及其危险因素。方法采用多中心横断面研究和病例一病例对照研究。收集全国12家医院2004年5月至12月连续就诊的1～6个月内脑梗死患者720例的临床资料。分别对头 MRI 显示的脑梗死部位、大小、血管分布、血管类型做出判断,用年龄相关性白质改变评分法(Age-Related White Matter Changes Scales,ARWMC)测量脑白质病变,阅片者不了解患者的临床资料。采用 Logistic 回归检验独立危险因素。结果 MRI 图像质量完好700例[平均年龄(59.93±9.86)岁,男/女为481/219],WML 患病率77.4%,随年龄增长患病率和病变严重程度增加。额叶病变最多,程度最重。Logistic 回归显示高龄(OR 1.09,95%CI1.067～1.114)、舒张压升高(OR 1.039,95%CI1.018～1.06)、基底节梗死(OR2.244,95%CI1.609～3.708)与 WML 存在独立相关。结论脑梗死患者 WML 普遍存在。病变以额叶最明显。高龄、舒张压升高、基底节梗死是发生 WML 的独立危险因素。
Objective To investigate the prevalence and risk factors of white matter lesions (WML) in patients with cerebral infarction. Methods A multicenter cross-sectional study and a case-control study were performed. The clinical data of 720 patients with cerebral infarction within 1 ~ 6 months from May to December in 2004 were collected. The cerebral infarction location, size, blood vessel distribution and blood vessel type of the head MRI were respectively evaluated. The age-related White Matter Changes Scales (ARWMC) were used to measure the white matter lesions, and the readers did not know the patients The clinical data. Logistic regression was used to test independent risk factors. Results The MRI image quality was good in 700 cases [mean age (59.93 ± 9.86) years, male / female 481/219]. The prevalence of WML was 77.4%. The prevalence and severity of MRI increased with age. Most frontal lobe lesions, the degree of the heaviest. Logistic regression showed that the elderly (OR 1.09, 95% CI 1.067-1.114), diastolic blood pressure (OR 1.039, 95% CI 1.018-1.06), basal ganglia infarction (OR2.244, 95% CI 1.609-3.708) Independently related to the existence of WML. Conclusion WML is common in patients with cerebral infarction. Lesions to the frontal most obvious. Older age, increased diastolic blood pressure, basal ganglia infarction is an independent risk factor for the occurrence of WML.