Prospective study of single and multiple lacunar infarcts using magnetic resonance imaging -: Risk factors, recurrence, and outcome in 175 consecutive cases
Prospective study of single and multiple lacunar infarcts using magnetic resonance imaging -: Risk factors, recurrence, and outcome in 175 consecutive cases
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DOI：
10.1161/01.str.0000090351.41662.91
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发表时间：
2003-10-01
期刊：
影响因子：
8.3
通讯作者：
Higuera, J
中科院分区：
文献类型：
--
作者：
Arauz, A;Murillo, L;Higuera, J
背景和目的：我们研究了伴有bbb1腔隙的腔隙性梗死（LI）患者是否具有不同的血管危险因素、不同的预后以及与单一腔隙患者相比更差的功能结局。方法：该研究纳入175例首次LI患者。根据存在多个LI （n=136）或单个LI （n=39）进行分组。通过包括年龄、性别和心脏疾病在内的logistic回归模型，研究单一或多重LI与主要血管危险因素、白质变、预后和复发的关系。结果：单次和多次LI在年龄、高血压、高脂血症、吸烟和大量饮酒方面无显著差异。糖尿病（优势比[OR]， 2.43; 95% CI, 1.09 ~ 5.4）、高水平的红细胞压积（比值比[OR]， 0.47）（比值比，1.09;95% CI, 1.04 ~ 1.21）和白质变（比值比，3.58;95% CI, 1.77 ~ 7.51）与多重LI显著相关，但与单一LI无关。单一LI组卒中复发率为7.7%，多发性LI组为24.3% （OR, 3.84; 95% CI, 1.1 - 13.3）。在中位随访12个月（6至156个月）期间，94%的单一LI患者和77.2%的多重LI患者预后良好（Rankin量表评分0至2）（OR, 5.4; 95% CI， 1.25至23.9）。结论：糖尿病、白质变和高红细胞压积是bbb1li患者的重要危险因素。多发LI的存在不仅是功能恢复的重要预后指标，也是复发率较高的重要预后指标。
Background and Purpose-We investigated whether lacunar infarct (LI) patients with >1 lacune have different vascular risk factors, a different prognosis, and poorer functional outcome than those with a single lacune.Methods-The study included 175 first-ever LI patients. The group was divided according to the presence of multiple (n=136) or single (n=39) LI. The association of single or multiple LI with the principal vascular risk factors, leukoaraiosis, outcome, and recurrence was investigated with logistic regression models that included age, sex, and cardiac disease.Results-No significant differences were found between single and multiple LI with respect to age, hypertension, hyperlipidemia, smoking, and heavy alcohol drinking. Diabetes mellitus (odds ratio [OR], 2.43; 95% CI, 1.09 to 5.4), high levels of hematocrit (>0.47) (OR, 1.09; 95% CI, 1.04 to 1.21), and leukoaraiosis (OR, 3.58; 95% CI, 1.77 to 7.51) were significantly related to multiple but not to single LI. Stroke recurrence rate was 7.7% in patients with single LI and 24.3% in the multiple LI group (OR, 3.84; 95% CI, 1.1 to 13.3). During a median follow-up of 12 months (range, 6 to 156 months), 94% of the single LI patients and 77.2% of the multiple LI patients had favorable outcomes (Rankin Scale score 0 to 2) (OR, 5.4; 95% CI, 1.25 to 23.9).Conclusions-Diabetes mellitus, leukoaraiosis, and high levels of hematocrit are important risk factors in patients with >1 LI. The presence of multiple LI may be an important prognostic indicator not only for functional recovery but also for a higher rate of recurrence.