Study for the prevention of ischemic stroke in patients with asymptomatic cerebrovascular disease

本研究的目的是观察无症状性脑病变（包括血管周围间隙、无症状性脑梗死（ACI）、脑室周围高信号（PVH）和深部及皮质下白色高信号（DSWMH））5年的时间变化，评价无症状性脑病变与危险因素的关系，阐明药物治疗对无症状性脑病变的影响。招募了117例无症状脑血管病患者（平均年龄67±11岁）。PVH+DSWMH评分与登记时相比显著变差，但独立检查时无显著变化。3 ~ 5 mm、5 ~ 10 mm以下梗死灶数及5年内梗死灶总面积均较登记时明显增加。65岁以上组的3年和4年期梗死数量显著增加， ...更多信息 在65岁以下的人群中。高血压组DSWMH和PVH+DSWMH评分较非高血压组明显加重。总胆固醇水平对无症状脑损伤没有影响，但与正常或高HDL胆固醇水平组相比，低HDL胆固醇水平组在1年和5年期间的梗死数量显着增加。与甘油三酯水平正常组相比，甘油三酯水平异常组在3年期间的PVH和PVH+DSWMH评分也显示出显著恶化。血糖水平异常组1年时PVH评分较血糖水平正常组明显加重。最后，与未使用抗血小板药物治疗的组相比，使用抗血小板药物治疗的组在3至5年期间的梗死数量显著减少。这些结果可能导致对ACI患者的症状性梗死的预防策略。少

The aim of this study is to observe the chronological changes of asymptomatic cerebral lesions on MRI, including perivascular spaces, Asymptomatic Cerebral Infarction (ACI), Periventricular Hyperintensity (PVH), and Deep and Subcortical White Matter Hyperintensity (DSWMH) for 5 years, to evaluate the relation between asymptomatic cerebral lesions and the risk factors, and to clarify the effects of medical treatments on asymptomatic cerebral lesions. One hundred seventeen patients with asymptomatic cerebrovascular disease (mean age, 67±11 years) were recruited. The score of PVH+DSWMH significantly became worse compared with on registration, although there was no significant change when it was examined independently. The number of infarct under 3 - 5 mm, 5 - 10 mm, and the whole size of the infarct for 5 years were significantly increased compared with on registration. The number of infarct at 3- and 4- year period in the group over 65 years old was significantly increased compared with … More that in the group under 65 years old. Hypertensive group showed a significant exacerbation in the score of DSWMH and PVH+DSWMH, compared to non-hypertensive group. There was no effect of total cholesterol level on asymptomatic cerebral lesions, but the group with low HDL cholesterol level showed a significant increase in the number of infarct at 1- and 5- year period, compared to the group with normal or high HDL cholesterol level. The group with abnormal triglyceride level also showed a significant exacerbation in the score of PVH and PVH+DSWMH at 3-year period compared to the group with normal triglyceride level. The group with abnormal blood glucose level showed a significant exacerbation in the score of PVH at 1-year period compared to the group with normal blood glucose level. Finally, the group treated with anti-platelet agents demonstrated a significant reduction in the number of infarct at 3 to 5- year period compared to the group treated without anti-platelet agents. These results may lead to the preventive strategy against symptomatic infarct in patients with ACI. Less