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

本研究的目的是观察5年无症状性脑病变的MRI时间变化，包括血管周围间隙、无症状性脑梗死（ACI）、心室周围高强度（PVH）、深部及皮层下白质高强度（DSWMH），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。纳入117例无症状脑血管病患者（平均年龄67±11岁）。PVH+DSWMH评分与登记时相比明显变差，尽管独立检查时没有显着变化。3 ~ 5mm、5 ~ 10mm以下的梗死灶数量和5年梗死灶总面积均显著高于对照组。65岁以上年龄组3年和4年梗死数明显高于65岁以下年龄组。与非高血压组相比，高血压组患者的DSWMH评分和PVH+DSWMH评分均明显加重。总胆固醇水平对无症状性脑损伤没有影响，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PVH评分和PVH+DSWMH评分在3年期间也明显加重。血糖异常组1年时PVH评分较血糖正常组明显加重。最后，与不使用抗血小板药物治疗组相比，使用抗血小板药物治疗组在3至5年期间的梗死数量显着减少。这些结果可能导致ACI患者对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