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目的踝肱指数(ABI)异常和心脑血管病事件的发生显著相关,但关于ABI水平与脑微出血(CMB)的相关性研究较少。文中旨在探讨异常ABI(≤0.9)和CMB发生及分布模式的相关性。方法连续纳入2015年1月至2015年12月入住于江苏省第二中医院神经内科诊断为脑梗死的患者187例。根据磁共振检查结果分为CMB阴性组115例和CMB阳性组72例(CMBs阳性)。根据CMB部位,又分为单纯脑叶组20例,深部CMB组24例,混合CMB组28例。单因素分析组间差异,同时多因素logistic回归分析ABI≤0.9与CMB的发生及分布的相关性。结果患者中ABI≤0.9者57例(30.5%)。与CMB阴性组ABI≤0.9发生率比较,CMB阳性组显著升高(22.6%vs 43.1%,P=0.003)。ABI水平和CMB数量存在显著负相关(r=-0.211,P=0.006)。多元logistic回归分析校正混杂因素后示:ABI≤0.9是缺血性脑血管病患者发生CMB(OR=2.363;95%CI:1.181~4.729)、深部CMB(OR=3.434;95%CI:1.283~9.187)及混合CMB(OR=2.837;95%CI:1.098~7.333)的危险因素。结论 ABI下降的急性脑梗死患者较易发生CMB,尤其是深部CMB。
The purpose of ankle brachial index (ABI) abnormalities and cardiovascular and cerebrovascular events were significantly related, but on the ABI level and cerebral micro-hemorrhage (CMB) less studied. The purpose of this paper is to explore the relationship between abnormal ABI (≤0.9) and CMB occurrence and distribution patterns. Methods A total of 187 patients diagnosed as cerebral infarction admitted to Department of Neurology, Second Hospital of Traditional Chinese Medicine from January 2015 to December 2015 were included. According to the results of MRI, there were 115 CMB negative patients and 72 CMB positive patients (positive CMBs). According to the CMB site, it was divided into simple brain lobe group 20 cases, deep CMB group 24 cases, mixed CMB group 28 cases. Univariate analysis of differences between groups, while multivariate logistic regression analysis ABI≤0.9 and the occurrence and distribution of CMB correlation. Results In patients with ABI ≤ 0.9 57 cases (30.5%). Compared with the incidence of ABI≤0.9 in CMB negative group, CMB positive group was significantly higher (22.6% vs 43.1%, P = 0.003). There was a significant negative correlation between ABI level and CMB number (r = -0.211, P = 0.006). Multivariate logistic regression analysis showed that the correction of confounding factors showed that ABI ≤0.9 was associated with CMB (OR = 2.363; 95% CI: 1.181-4.729), deep CMB (OR = 3.434; 95% CI: 1.283 ~ 9.187) and mixed CMB (OR = 2.837; 95% CI: 1.098 ~ 7.333) risk factors. Conclusions Patients with acute cerebral infarction with decreased ABI are more likely to develop CMB, especially deep CMB.