Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people - The cardiovascular health study
Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people - The cardiovascular health study
复制标题
DOI：
10.1161/01.str.27.8.1274
复制
发表时间：
1996-08-01
期刊：
影响因子：
8.3
通讯作者：
Fried, L
中科院分区：
文献类型：
--
作者：
Longstreth, WT;Manolio, TA;Fried, L
背景与目的
我们的目的是确定老年人头颅磁共振成像（MRI）上白质病变的潜在危险因素及其临床表现。
方法
利用医疗保险资格名单获取了5888名65岁及以上社区居住者的代表性样本。在3301名接受MRI扫描且否认有中风或短暂性脑缺血发作病史的参与者中寻找白质病变的相关因素。参与者在基线和随访时接受了广泛的标准化评估，包括标准问卷、体格检查、多项血液检测、心电图、肺功能检测、颈动脉超声和M型超声心动图。神经放射学家在不了解临床信息的情况下将白质病变从0分（无）到9分（最重）进行分级。
结果
许多潜在危险因素与白质分级相关，但在多变量模型中，显著（所有P <.01）且独立与分级升高相关的因素包括年龄较大、MRI显示的无症状性中风、收缩压较高、第1秒用力呼气量（FEV₁）较低以及年收入低于50000美元。如果不考虑FEV₁，在模型中则由女性、吸烟史以及基线检查时医生诊断的高血压病史替代。许多临床特征与白质分级相关，尤其是那些表明认知和下肢功能受损的特征。
结论
白质病变与年龄、无症状性中风、高血压、FEV₁和收入显著相关。由于白质病变与认知和下肢功能受损相关，因此可能不应将其视为良性。
Background and Purpose Our aim was to identify potential risk factors for and clinical manifestations of white matter findings on cranial MRI in elderly people.Methods Medicare eligibility lists were used to obtain a representative sample of 5888 community-dwelling people aged 65 years or older. Correlates of white matter findings were sought among 3301 participants who underwent MRI scanning and denied a history of stroke or transient ischemic attack. Participants underwent extensive standardized evaluations at baseline and on follow-up, including standard questionnaires, physical examination, multiple blood tests, electrocardiogram, pulmonary function tests, carotid sonography, and M-mode echocardiography. Neuroradiologists graded white matter findings from 0 (none) to 9 (maximal) without clinical information.Results Many potential risk factors were related to the white matter grade, but in the multivariate model the factors significantly (all P < .01) and independently associated with increased grade were greater age, clinically silent stroke on MRI, higher systolic blood pressure, lower forced expiratory volume in 1 second (FEV(1)), and income less than $50 000 per year. If excluded, FEV(1) was replaced in the model by female sex, history of smoking, and history of physician-diagnosed hypertension at the baseline examination, Many clinical features were correlated with the white matter grade, especially those indicating impaired cognitive and lower extremity function.Conclusions White matter findings were significantly associated with age, silent stroke, hypertension, FEV(1), and income. The white matter findings may not be considered benign because they are associated with impaired cognitive and lower extremity function.