Prevalence, incidence, and risk factors of lacunar infarcts in a community sample
Prevalence, incidence, and risk factors of lacunar infarcts in a community sample
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DOI：
10.1212/wnl.0b013e3181aa52ea
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发表时间：
2009-07-28
期刊：
影响因子：
9.9
通讯作者：
Sachdev, Perminder S.
中科院分区：
文献类型：
--
作者：
Chen, Xiaohua;Wen, Wei;Sachdev, Perminder S.
背景：腔隙性梗塞是直径不超过2厘米的小空洞病变。尽管通常无症状，但它们被认为是血管性痴呆的重要病理基础。腔隙性脑梗死的患病率和危险因素概况已有不同的报道，但大规模社区数据的发病率数据很少。 方法：作为 PATH Through Life 研究的一部分，从 60-64 岁社区居民的选民名册中随机招募参与者 (n = 477)。收集人口统计信息和危险因素数据，并分两波（相隔 4 年）进行 MRI 脑部扫描。在 T1 加权和 T2 加权液体衰减反转恢复图像上评估腔隙性梗塞的数量和位置以及其他体积数据。结果：在第 1 波中，37 名 (7.8%) 参与者至少有一个腔隙性梗塞。第 2 波中有 6 名（6/375，1.6%）参与者检测到新的腔隙性梗塞。第 1 波出现的腔隙平均体积在 4 年内从 53.90 毫米（3）显着增加到 69.86 毫米（3）。高血压（比值比 [OR] = 1.6；95% 置信区间 [CI] = 1.01-2.60）、前脑室-脑比 (%)（OR = 1.02；CI = 1.003-1.036）和白质高信号体积（OR = 4.9；CI = 1.53-15.80）与腔隙性脑卒中患病率独立相关。结论： 60 多岁的人大脑中常见的偶然发现的腔隙，其发生率和大小随着年龄的增长而增加。高血压是主要的可治疗危险因素，腔隙性梗塞通常与 T2 加权成像上严重的白质高信号相关。神经病学（R）2009； 73：266-272
Background: Lacunar infarcts are small cavitated lesions no larger than 2 cm in diameter. Although often asymptomatic, they have been suggested as an important pathologic substrate of vascular dementia. The prevalence and risk factor profile of lacunar infarction has been variously reported, but the incidence data are scarce for large community-based data.Methods: Participants (n = 477) were recruited randomly from the electoral roll of community residents aged 60-64 years as part of the PATH Through Life Study. Demographic information and risk factor data were collected and MRI brain scans performed in two waves, 4 years apart. The number and locations of lacunar infarcts as well as other volumetric data were assessed on T1-weighted and T2-weighted fluid-attenuated inversion recovery images.Results: In wave 1, 37 (7.8%) participants had at least one lacunar infarct. New lacunar infarcts were detected in 6 (6/375, 1.6%) participants at wave 2. Lacunes present at wave 1 increased significantly in mean volume from 53.90 to 69.86 mm(3) over 4 years. Hypertension (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.01-2.60), anterior ventricle-brain ratio (%) (OR = 1.02; CI = 1.003-1.036), and volume of white matter hyperintensities (OR = 4.9; CI = 1.53-15.80) were independently associated with the prevalence of lacunar infarction.Conclusion: Lacunes were common incidental findings in the brains of individuals in their 60s, and their prevalence as well as size increased with age. Hypertension was the major treatable risk factor, and lacunar infarction was usually associated with severe white matter hyperintensities on T2-weighted imaging. Neurology (R) 2009; 73: 266-272