Risk factors for microangiopathy-related cerebral damage in the Austrian stroke prevention study
Risk factors for microangiopathy-related cerebral damage in the Austrian stroke prevention study
复制标题
DOI：
10.1016/s0022-510x(97)00137-8
复制
发表时间：
1997-11-06
影响因子：
4.4
通讯作者：
Esterbauer, H
中科院分区：
文献类型：
--
作者：
Schmidt, R;Fazekas, F;Esterbauer, H
微血管病变相关脑损伤(MARCD)是老年人常见的偶然MRT表现。这些发现的风险因素目前还不得而知。因此，我们对349名随机选择的没有神经精神疾病的志愿者(年龄在50岁到70岁之间)进行了磁共振成像，并评估了MARCD与常规和最近建议的脑血管危险因素(如载脂蛋白E基因型别、血浆必需抗氧化剂浓度和抗心磷脂抗体效价)的相关性。MARCD被定义为早期融合和融合的深部白质高信号和腔隙的证据。71例(20.3%)受试者出现。患有慢性阻塞性肺疾病的患者比未发现此类发现的患者年龄更大(62.7vs59.6岁；P=0.0001)。他们的动脉高血压(45.1%比28.1%；P=0.006)和心脏病(50.7%比37.1%；P=0.04)，检查时的收缩压读数(144.4毫米汞比136.7毫米汞；P=0.004)，以及更高的血清纤维蛋白原浓度(327.1 mg/dl比292.5 mg/dl；P=0.001)。总胆固醇(217.6 mg/dl对231.2 mg/dl；P=0.009)、载脂蛋白A-I(167.3 mg/dl对177.4 mg/dl，P=0.02)、番茄红素(0.171 mU/L对0.24mU/L；P=0.003)、视黄醇(1.91mU/L对2.10mU/L；P=0.02)和α-生育酚(27.55mU/L对31.14mU/L；P=0.001)。通过前向逐步回归分析，建立了MARCD的独立预测因素模型，年龄第一(优势比2.01/10岁)、纤维蛋白原第二(优势比2.45/100 mg/dl)、α-生育酚第三(优势比0.55/10 Mol/L)、动脉高血压第四(优势比1.96)。MARCD与各种可治疗的临床情况的关联可能具有预防意义。(C)1997年爱思唯尔科学公司。
Microangiopathy-related cerebral damage (MARCD) represents a common incidental MRT observation in the elderly. The risk factors of such findings are widely unknown. We therefore performed MRI in 349 randomly selected volunteers (ages 50 to 70 years) without neuropsychiatric disease, and evaluated the association of MARCD with conventional and recently suggested cerebrovascular risk factors such as apolipoprotein E genotypes, plasma concentrations of essential antioxidants and anticardiolipin antibody titres. MARCD was defined as evidence of early confluent and confluent deep white matter hyperintensities and lacunes. It was present in 71 (20.3%) subjects. Individuals with MARCD were older than those without such findings (62.7 years vs 59.6 years; P=0.0001). They had a higher rate of arterial hypertension (45.1% vs 28.1%; P=0.006) and cardiac disease (50.7% vs 37.1%; P=0.04), higher systolic blood pressure readings at exam (144.4 mmHg vs 136.7 mmHg; P=0.004), and higher serum fibrinogen concentrations (327.1 mg/dl vs 292.5 mg/dl; P=0.001). Their levels of total cholesterol (217.6 mg/dl vs 231.2; P=0.009), apolipoprotein A-I (167.3 mg/dl vs 177.4 mg/dl, P=0.02), lycopene (0.171 mu mol/l vs 0.24 mu mol/l; P=0.003), retinol (1.91 mu mol/l vs 2.10 mu mol/l; P=0.02) and alpha-tocopherol (27.55 mu mol/l vs 31.14 mu mol/l; P=0.001) were significantly lower. Forward stepwise regression analysis created a model of independent predictors of MARCD with age entering first (odds ratio 2.01/10 years), fibrinogen second (odds ratio 2.45/100 mg/dl), alpha-tocopherol third (odds ratio 0.55/10 mu mol/l), and arterial hypertension fourth (odds ratio 1.96). The association of MARCD with various treatable clinical conditions may have preventive implications. (C) 1997 Elsevier Science B.V.