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目的探讨腔隙性脑梗死患者合并脑微出血(cerebral microbleeds,CMBs)的临床及其影像学特征。方法采用前瞻性研究方法,连续收集2013年8月~2015年9月在本院神经内科住院的腔隙性脑梗死患者120例,根据有无CMBs将患者分为有CMBs组(39例)和无CMBs组(81例),比较2组间基本临床资料、生化指标及影像学特点是否存在差异,并采用多因素逐步Logistic回归模型分析CMBs发生的独立危险因素。结果 120例腔隙性脑梗死患者中合并CMBs39例(32.5%),其中2组年龄(t=6.373,P<0.001)、高血压病(χ~2=5.385,P=0.02)、高尿酸(χ~2=4.474,P=0.04)、腔隙性脑梗死数目(t=8.773,P<0.001)以及脑白质疏松程度评分(t=7.964,P<0.001)比较差异具有统计学意义。Logistic回归分析显示,年龄、高血压病、腔隙性脑梗死数目以及脑白质疏松程度评分是腔隙性脑梗死患者发生CMBs的独立危险因素。结论腔隙性脑梗死患者CMBs发生与年龄、高血压病、腔隙性脑梗死数目以及脑白质疏松程度有关。
Objective To investigate the clinical and imaging features of cerebral microbleeds (CMBs) in patients with lacunar infarction. Methods A prospective study was conducted to collect 120 patients with lacunar infarction hospitalized in our department of neurology from August 2013 to September 2015. The patients were divided into CMBs group (39 cases) and non-CMBs group There were no CMBs group (n = 81). The clinical data, biochemical indexes and imaging features of two groups were compared. The independent risk factors of CMBs were analyzed by multivariate stepwise Logistic regression model. Results There were 39 patients (32.5%) with CMBs in 120 patients with lacunar infarction, including 2 age groups (t = 6.373, P <0.001), hypertension (χ ~ 2 = 5.385, There was significant difference between the number of lacunar infarction (t = 8.773, P <0.001) and the degree of leukoaraiosis (t = 7.964, P <0.001). Logistic regression analysis showed that age, hypertension, lacunar infarction number and leukoaraiosis score were independent risk factors of CMBs in patients with lacunar infarction. Conclusion The occurrence of CMBs in patients with lacunar infarction is related to age, hypertension, the number of lacunar infarction and the degree of leukoaraiosis.