头颈部大动脉粥样硬化与脑白质疏松相关性分析

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摘要目的：采用DSA评估头颈部大动脉粥样硬化（LAA）、头颅MRI评估脑白质疏松（LA），进一步明确头颈部LAA和LA间的关系。方法：本研究共纳入231例脑梗死或短暂性脑缺血发作的患者，所有患者住院期间均接受头颅MRI和DSA检查，同时记录患者基本情况和血管粥样硬化的危险因素。根据Fazekas量表分为“显著”LA病变组和“无或轻度”LA病变组，然后通过单因素和logistic回归分析来明确其危险因素。结果：LA与颈动脉狭窄相关程度最高（r=0.30，P＜0.001）；年龄（OR 1.11，95%CI 1.07～1.15，P＜0.001）、高血压（OR 3.64，95%CI 1.61～8.20，P=0.002）、中度颈动脉狭窄（OR 4.49，95%CI 1.54～13.13，P＜0.01）和重度颈动脉狭窄（OR4.29，95%CI 1.69～10.90，P=0.002）均是LA独立的危险因素。结论：LAA与LA存在相关
性，颈动脉狭窄是LA的独立危险因素。

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	吕洋辉
	何松彬
	唐维国
	孙茂军
	王斌达
	周琳
	叶指南

关键词 ：脑白质疏松, 大动脉粥样硬化, 血管造影术

Abstract：Objective: To explore the correlation between large artery atherosclerosis (LAA) and leukoaraiosis (LA), that the assessment of LAA and LA were using by DSA and cranial MRI. Methods: A total of 231 cerebral infarction or TIA patients were enrolled, all of them were underwent cranial MRI and DSA examinations. The cerebral vascular risk factors were also collected. According to the Fazekas scale, all patients were divided into two groups, the “significant LA” group and the “little or no LA” group. A univariate and logistic regression analysis were used to determine the independent risk factors for LA. Results: The highest correlation was found between carotid artery stenosis and LA (r=0.30, P<0.001). Age (OR value 1.11, 95%CI 1.07-1.15; P<0.001), hypertension (OR value 3.64, 95%CI 1.61-8.20, P=0.002), moderate carotid stenosis (OR value 4.49, 95%CI 1.54-13.13, P=0.006) and severe carotid stenosis (OR value 4.29, 95%CI 1.69-10.90, P=0.002) were independent risk factors for LA. Conclusion: There is a close correlation between LAA and LA, carotid artery stenosis was an independent risk factors for LA.

Key words： leukoaraiosis large artery atherosclerosis digital subtraction angiography

收稿日期: 2014-02-14

基金资助:浙江省医药卫生平台计划重点资助项目（2014ZDA 026）。

通讯作者: 唐维国，主任医师，教授，Email：tangweiguo2003@ 163.com。

作者简介: 吕洋辉（1986-），男，浙江湖州人，硕士生。现工作单位：德清县人民医院。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2014/V44/I12/872

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