摘要
目的:通过对腔隙性脑梗死与其他类型脑卒中血管危险因素的比较,推测腔隙性脑梗死的小血管病理改变类型,以便为其早期防治提供依据。方法:前瞻性登记2002-03/2004-01连续入院的腔隙性脑梗死、原发性脑出血及皮质型梗死患者的血管危险因素,包括高血压、糖尿病、吸烟史、饮酒史、脑卒中家族史、缺血性心脏病、短暂性脑缺血发作史、颈动脉狭窄、超重及高胆固醇血症等,引入Logistic回归进行单因素及多因素分析,对3类脑卒中的血管危险因素进行比较。结果:共登记脑卒中患者1263例,其中698例符合纳入标准,其中腔隙性脑梗死303例,原发性脑出血203例,皮质型脑梗死192例。①腔隙性脑梗死组与原发性脑出血组比较,高血压的分布无统计学差异(57.1%比51.7%;OR=1.24,P>0.05),糖尿病、高胆固醇血症在腔隙性脑梗死组更常见(19.5%比4.9%,25.0%比14.7%;OR=4.67,1.92,P<0.05)。②腔隙性脑梗死组与皮质型梗死组比较,糖尿病的分布没有统计学差异(19.5%比14.1%;OR=1.24,P>0.05),男性,高血压和高胆固醇血症在腔梗组更常见(61.1%比52.1%;57.1%比44.8%,25.0%比16.2%;OR=1.44,1.73,1.73,P<0.05)。结论:①腔隙性脑梗死与原发性脑出血比较,糖尿病、高胆固醇血症与前者的关系更明显。②腔隙性脑梗死与皮质型梗死比较。
AIM:To study the vasculopathy in lacunar cerebral infarction based on the comparison of vascular risk factor between lacunar cerebral infarction and other kinds of stroke,so as to provide data for early prevention and cure. METHODS:Data of hypertension,diabetes mellitus,smoking,alcohol,stroke history,ischemic heart disease,transient ischemic attack,carotid stenosis,obesity and hypercholesterolemia were collected from stroke patients admitted consecutively from March 2002 to January 2004.Logistic regression analysis was used in comparing the frequency of several vascular risk factors between patients with lacunar cerebral infarction and patients with primary intracerebral hemorrhage,and those with cortex infarction. RESULTS:A total of 698 among 1 236 stroke patients met the inclusion criteria,among which,303 were lacunar cerebral infarction,203 were primary intracerebral hemorrhage and 192 were cortex infarction patients.①LI versus primary intracerebral hemorrhage:There was no statistically significant difference in hypertension(57.1%vs 51.7%;OR=1.24,P > 0.05) between the two groups.There was significant difference in diabetes(19.5%vs 4.9%;OR=4.67,P< 0.05) and hypercholesterolemia(25.0%vs 14.7%;OR=1.92,P< 0.05) between the two groups,more frequent in lacunar cerebral infarction than primary intracerebral hemorrhage.②Lacunar cerebral infarction versus cortex infarction:There was no statistically significant difference in diabetes between the two groups(19.5%vs 14.1%;OR=1.24,P > 0.05).Male gender(61.1%vs 52.1%;OR=1.44,P< 0.05),hypertension(57.1%vs 44.8%;OR=1.73,P< 0.05) and hypercholesterolemia(25.0%vs 16.2%;OR=1.73,P< 0.05) were more frequent in lacunar cerebral infarction than cortex infarction. CONCLUSION:①Lacunar cerebral infarction versus primary intracerebral hemorrhage:Diabetes and hypercholesterolemia are more strongly associated with lacunar cerebral infarction than with primary intracerebral hemorrhage.②Lacunar cerebral infarction versus cortex infarction:Diabetes is associated with lacunar cerebral infarction as well as with cortex infarction.③The results support the hypothesis that except for hyaline degeneration,small vessel atherosclerosis can be an important subtype of vasculopathy in lacunar cerebral infarction.
出处
《中国临床康复》
CSCD
北大核心
2005年第13期104-106,共3页
Chinese Journal of Clinical Rehabilitation
