本文選題：腦白質(zhì)疏松 + 危險(xiǎn)因素　； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：腦白質(zhì)疏松，是指經(jīng)常在老年人頭CT和MRI檢查中出現(xiàn)的腦白質(zhì)的異常信號(hào)改變，被廣泛認(rèn)為與高齡、高血壓、糖尿病、腔隙性腦梗死及腦卒中史有關(guān)。近年來，由于CT和MRI等影像檢查技術(shù)在腦血管疾病中的廣泛應(yīng)用，該病的檢出率明顯提高。盡管有多個(gè)研究表明了腔隙性腦梗死患者的腦白質(zhì)疏松患病率顯著提高，腦白質(zhì)疏松患者的腔隙性腦梗死檢出率也明顯增加，且兩者有多個(gè)共同的危險(xiǎn)因素，進(jìn)而認(rèn)為兩者同為腦的小血管疾病，但針對腦白質(zhì)疏松的發(fā)病機(jī)制，國內(nèi)外尚未得出一致的結(jié)論。本研究通過對腦白質(zhì)疏松(LA)臨床相關(guān)危險(xiǎn)因素的研究，探討動(dòng)脈硬化與腦白質(zhì)疏松發(fā)生的關(guān)系以及腦白質(zhì)疏松可能的發(fā)病機(jī)制。 本研究嚴(yán)格按照入選與排除標(biāo)準(zhǔn)，從2013年1月～2013年11月在吉林大學(xué)中日聯(lián)誼醫(yī)院神經(jīng)內(nèi)科住院的患者中，收集符合研究條件且經(jīng)頭MRI檢查和依據(jù)Fazekas評分確診為腦白質(zhì)疏松的250例，作為病例組；確診無腦白質(zhì)疏松的221例，作為對照組。均完成頸部血管彩超、TCD和頭顱MRI及MRA等檢查。所有資料均采用SPSS2l．0軟件進(jìn)行儲(chǔ)存和處理，使用卡方檢驗(yàn)對計(jì)數(shù)資料如一般危險(xiǎn)因素進(jìn)行分析處理。再將有統(tǒng)計(jì)意義的危險(xiǎn)因素作為自變量，應(yīng)用二元Logistic回歸分析腦白質(zhì)疏松和危險(xiǎn)因素的關(guān)系，采用逐步進(jìn)入的方式，，p0．05為進(jìn)入標(biāo)準(zhǔn)，p0．1為退出標(biāo)準(zhǔn)。計(jì)量資料如PI、VS的比較采用t檢驗(yàn)，并以均數(shù)±標(biāo)準(zhǔn)差（x±s）表示，以P0．05認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果顯示：（1）在單因素分析中，年齡、高血壓、糖尿病、腦梗死病史、腔隙性腦梗死、頸內(nèi)動(dòng)脈狹窄及頸內(nèi)動(dòng)脈粥樣硬化斑塊均與腦白質(zhì)疏松的發(fā)生有關(guān)（PO．05）。（2）在多因素Logistic回歸分析中，年齡、腔隙性腦梗死及頸內(nèi)動(dòng)脈粥樣硬化斑塊均為腦白質(zhì)疏松的主要危險(xiǎn)因素(PO．05)。（3）在t檢驗(yàn)中，LA組左側(cè)MCA、ACA、PCA、VA及BA的脈動(dòng)指數(shù)均較對照組高，而收縮期血流速度(VS)較對照組低，差異均有統(tǒng)計(jì)學(xué)意義(PO．05)。 綜上，得出如下結(jié)論：（1）年齡、腔隙性腦梗死及頸內(nèi)動(dòng)脈粥樣硬化斑塊均為腦白質(zhì)疏松的主要危險(xiǎn)因素。（2）腦血流動(dòng)力學(xué)的變化與LA的發(fā)生相關(guān)。（3）推測供應(yīng)腦的大血管的動(dòng)脈硬化參與了LA的形成，慢性動(dòng)脈硬化可能是LA的病理生理基礎(chǔ)和過程。
[Abstract]:Leukoaraiosis refers to the abnormal signal changes of white matter which often appear in the head CT and MRI examination of the elderly. It is widely considered to be related to the history of old age hypertension diabetes lacunar infarction and cerebral apoplexy. In recent years, CT and MRI are widely used in cerebrovascular diseases. Although several studies have shown a significant increase in the prevalence of leukoaraiosis in patients with lacunar cerebral infarction, the detection rate of lacunar infarction in patients with leukoaraiosis has increased significantly, and both have multiple common risk factors. It is believed that both of them are small vascular diseases of the brain, but there is no consistent conclusion at home and abroad on the pathogenesis of leukoaraiosis. In this study, the relationship between arteriosclerosis and leukoaraiosis and the possible pathogenesis of leukoaraiosis were studied by studying the clinical risk factors of leukoaraiosis. From January 2013 to November 2013, patients hospitalized in the Department of Neurology, Sino-Japanese Friendship Hospital, Jilin University, were enrolled in the study according to the criteria of inclusion and exclusion. Two hundred and fifty cases of leukoaraiosis diagnosed by MRI examination and Fazekas score were collected as the case group and 221 cases as the control group. TCD, MRI and MRA were performed in all patients. All the data were stored and processed by SPSS2l.0 software, and the counting data such as general risk factors were analyzed and processed by chi-square test. Then the statistical risk factors were taken as independent variables, and the binary Logistic regression analysis was used to analyze the relationship between leukoaraiosis and risk factors. The measurement data such as PIV S were compared by t test, and expressed as mean 鹵standard deviation (x 鹵s), and the difference was statistically significant (P0.05). The results showed that in univariate analysis, age, hypertension, diabetes, history of cerebral infarction, lacunar infarction, Stenosis of internal carotid artery and atherosclerotic plaque of internal carotid artery were related to the occurrence of leukoaraiosis. Lacunar cerebral infarction and atherosclerotic plaque of internal carotid artery were the main risk factors of leukoaraiosis (P < 0. 05). The pulsation index of PCAVA and BA in left MCAA ACAA of LA group was higher than that in control group, while systolic blood flow velocity (VS) was lower than that in control group. The differences were statistically significant. In summary, the following conclusion is drawn: 1) Age, Lacunar infarction and atherosclerotic plaque of internal carotid artery were the main risk factors of leukoaraiosis. Chronic arteriosclerosis may be the pathophysiological basis and process of LA.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 任菁;高永紅;張英;;血壓晝夜節(jié)律對老年腦白質(zhì)疏松患者的影響[J];中國現(xiàn)代醫(yī)藥雜志;2011年06期

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