Differential risk factors for lacunar stroke depending on the MRI (white and red) subtypes of microangiopathy.
Differential risk factors for lacunar stroke depending on the MRI (white and red) subtypes of microangiopathy.
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DOI：
10.1371/journal.pone.0044865
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Bang OY
中科院分区：
文献类型：
--
作者：
Park JH;Ryoo S;Kim SJ;Kim GM;Chung CS;Lee KH;Bang OY
急性腔隙性脑卒中患者通常同时存在脑白质病变和脑微出血（CMB），它们代表着脑微血管病变。由于它们可能对卒中预后和治疗有不同的影响，因此了解以白质变为主和以cmb为主的微血管病变的相关因素是很重要的。我们前瞻性地招募226例急性腔隙性梗死患者，根据Fazekas评分和是否存在CMB分为4组：轻度、红色（以CMB为主）、白色（以白质病变为主）和重度微血管病变组。为了比较，我们还评估了50例脑出血（ICH）患者。我们评估了急性腔隙性卒中患者微血管病变亚型的临床和实验室表现，并将其与原发性脑出血患者进行了比较。两组之间的危险因素情况不同。急性腔隙性梗死但有轻度微血管病变的患者较年轻，以男性为主，高血压较少，吸烟和重度饮酒习惯较其他组多。红色微血管病变的危险因素与脑出血相似，但与白色微血管病变不同。与红色微血管病变组和脑出血组相比，白色微血管病变组的受试者年龄更大，患糖尿病的频率更高。调整其他因素后，年龄[优势比（OR） 1.13；95%置信区间（CI） 1.08-1.18；p<0.001]和糖尿病（OR 2.28; 95% CI 1.02-5.13; p = 0.045）与白色微血管病变独立相关，与轻度微血管病变相比，年龄（OR 1.05; 95% CI 1.01-1.08; p = 0.010）是红色微血管病变的独立预测因子。急性腔隙性梗死患者有不同的危险因素概况取决于微血管病变的发现。我们的研究结果表明，糖尿病可能是白色微血管病变的决定因素之一，而相对年轻的人吸烟和饮酒习惯可能是腔隙性梗死患者轻度微血管病变的决定因素。
Leukoaraiosis and cerebral microbleeds (CMB), which represent cerebral microangiopathy, commonly coexist in patients with acute lacunar stroke. Since they may have different impacts on stroke prognosis and treatment, it is important to know the factors associated with leukoaraiosis-predominant vs. CMB-predominant microangiopathies. We prospectively recruited 226 patients with acute lacunar infarction and divided them into four groups according to the Fazekas’ score and the presence of CMB: mild, red (predominant CMB), white (predominant leukoaraiosis) and severe microangiopathy groups. For comparison, we also evaluated 50 patients with intracerebral hemorrhage (ICH). We evaluated the clinical and laboratory findings of microangiopathy subtypes in patients with acute lacunar stroke and then compared them with those of primary ICH. The risk factor profile was different among the groups. Patients with acute lacunar infarct but mild microangiopathy were younger, predominantly male, less hypertensive, and more frequently had smoking and heavy alcohol habits than other groups. The risk factor profile of red microangiopathy was similar to that of ICH but differed from that of white microangiopathy. The subjects in the white microangiopathy group were older and more frequently had diabetes than those in the red microangiopathy or ICH group. After adjustments for other factors, age [odds ratio (OR) 1.13; 95% confidence interval (CI) 1.08–1.18; p<0.001] and diabetes (OR 2.28; 95% CI 1.02–5.13; p = 0.045) were independently associated with white microangiopathy, and age (OR 1.05; 95% CI 1.01–1.08; p = 0.010) was independent predictor for red microangiopathy compared to mild microangiopathy. Patients with acute lacunar infarction have a different risk factor profile depending on microangiopathic findings. Our results indicate that diabetes may be an one of determinants of white (leukoaraiosis-predominant) microangiopathy, whereas smoking and alcohol habits in relatively young people may be a determinants of mild microangiopahic changes in patients with lacunar infarction.
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影响因子：
9.9
作者：
Roob, G;Schmidt, R;Fazekas, F
通讯作者：
Fazekas, F
比较lacunar和非lacunar梗死之间的死亡风险和复发性血管事件。
影响因子：
14.5
作者：
Jackson, C;Sudlow, C
通讯作者：
Sudlow, C
影响因子：
16.2
作者：
通讯作者：
--
影响因子：
11.2
作者：
Ay, H;Furie, KL;Koroshetz, WJ
通讯作者：
Koroshetz, WJ
DOI：
10.1161/01.atv.0000258947.17570.38
发表时间：
2007-04-01
影响因子：
8.7
作者：
Aono, Yoko;Ohkubo, Takayoshi;Imai, Yutaka
通讯作者：
Imai, Yutaka