摘要
目的探讨脑小血管病中脑白质病变(WML)严重程度的影响因素及其与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的相关性。方法回顾性分析2015年7月—2021年7月在联勤保障部队第904医院和江南大学附属医院神经内科就诊住院并符合脑小血管病诊断标准的160例患者。收集患者性别、年龄、BMI和糖尿病、高血压病、卒中患病率及既往吸烟史,同时测定糖化血红蛋白、超敏C反应蛋白、甘油三酯、低密度脂蛋白胆固醇、尿酸、胱抑素、D-二聚体、同型半胱氨酸和纤维蛋白原浓度。根据头颅磁共振成像检查结果将上述脑小血管病患者分为无WML组、轻度WML组、中度WML组和重度WML组,对比分析各组间危险因素。同时依据多导睡眠图检查结果将上述患者分为无OSAHS组、轻度OSAHS组、中到重度OSAHS组,将上述患者的WML病变程度与OSAHS分级程度进行相关性分析。结果在脑小血管病患者中:(1)WML病变程度越高,患者的平均年龄越大,其高血压患病率和糖尿病患病率越高,各组间比较差异有统计学意义(P<0.05);(2)随着WML病变程度增高,各组间同型半胱氨酸和纤维蛋白原浓度越高,差异有统计学意义(P<0.05);(3)WML病变程度与OSAHS分级程度之间存在正相关性(P<0.05)。结论高龄、高血压病和糖尿病容易导致WML病变程度的增高;同型半胱氨酸和纤维蛋白原浓度的增高亦会导致WML病变程度的加重;OSAHS分级越严重的患者,WML病变程度也越严重。
Objective To investigate the factors affecting the severity of white matter lesions(WML)and its correlation with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods 160 patients hospitalized in the 904 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army and Affiliated Hospital of Jiangnan University from July 2015 to July 2021 were retrospectively analyzed.The patients were tested for glycosylated hemoglobin,high-sensitivity C-reactive protein,triglycerides,low-density lipoprotein cholesterol,uric acid,cystatin,D-dimer,and homocysteine and fibrinogen and their gender,age,BMI and prevalence of diabetes,hypertension,stroke,and previous smoking history were collected.According to the results of head magnetic resonance imaging,the patients were divided into no WML group,mild WML group,moderate WML group and severe WML group,and the risk factors between each group were compared and analyzed.At the same time,patients were divided into no OSAHS group,mild OSAHS group,and moderate-to-severe OSAHS group according to the results of polysomnography,and the correlation between the severity of WML and the severity of OSAHS was analyzed.Results(1)The higher the degree of WML classification,the older the average age of the patient,the higher the prevalence of hypertension and diabetes,and the comparison between groups was statistically significant(P<0.05).(2)As the degree of WML classification increased,the concentrations of homocysteine and fibrinogen were higher,and the difference was statistically significant(P<0.05).(3)There was a positive correlation between the severity of WML and the severity of OSAHS(P<0.05).Conclusion In patients with WML,advanced age,hypertension and diabetes can easily lead to an increase in the severity of WML.Increased concentrations of homocysteine and fibrinogen can also lead to aggravation of WML and the higher the OSAHS classification in severe patients,the degree of WML is more severe.
作者
赵继来
胡玲玲
刘勇
王挺刚
许岩
ZHAO Ji-lai;HU Ling-ling;LIU Yong;WANG Ting-gang;XU Yan(Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu,214062,China;The 904 Hospital of the JointLogistics Support Force of the Chinese People's Liberation Army,Wuxi,Jiangsu,214041,China)
出处
《中国血液流变学杂志》
CAS
2022年第2期217-221,共5页
Chinese Journal of Hemorheology
