心脑血管病防治2026，Vol.26Issue(8)：25-29,36,6.DOI:10.3969/j.issn.1009-816x.2026.08.005
脑小血管疾病患者脑白质高信号进展危险因素分析
Risk factors for progression of white matter hyperintensities in patients with cerebral small vessel disease
摘要
Abstract
Objective To investigate the risk factors for progression of white matter hyperintensities(WMHs)in patients with cerebral small vessel disease.Methods Clinical and imaging data of 200 patients with WMHs at Tongde Hospital of Zhejiang Province from May 2014 to November 2020 were collected and analyzed.All patients were followed up for 3-5 years and divided into a non-progression group(93 cases)and a progression group(107 cases)based on the WMHs progression.The severity of WMHs was assessed using the Fazekas scale,and the perivascular space(PVS)grading was evaluated by the Potter grading system(0-4 points).Lacunes of presumed vascular origin(LPVO)were recorded as present or absent.Baseline characteristics were compared between the two groups,and Logistic regression analysis was performed to identify risk factors for WMHs progression.A product term(baseline WMHs×baseline PVS)was introduced into the Logistic regression model to examine the interaction effect between the two variables.Results There were statistically significant differences between the progression group and the non-progression group in terms of age,smoking history,baseline LPVO,baseline PVS,and baseline WMHs(t/χ2/Z=-3.372,4.787,5.873,3.745,5.015,respectively;all P<0.05).Binary Logistic regression analysis showed that baseline PVS and baseline WMHs were associated with the progression of WMHs[OR(95%CI)=5.742(1.709-19.292),2.809(1.610-4.901),respectively;both P<0.01].Moreover,there was an interaction between baseline PVS and baseline WMHs on the progression of WMHs[OR(95%CI)=0.666(0.498-0.891),P<0.01].Conclusion Baseline PVS grade and baseline WMHs severity are closely correlated with the progression of WMHs,and there is an interaction between these two factors.关键词
脑小血管疾病/脑白质高信号/血管旁间隙Key words
Cerebral small vessel disease/White matter hyperintensities/Perivascular space引用本文复制引用
姜淑倩,周小力,蒋霞,余新杰,徐志华..脑小血管疾病患者脑白质高信号进展危险因素分析[J].心脑血管病防治,2026,26(8):25-29,36,6.基金项目
浙江省医药卫生科技计划项目(2022KY707,2024KY866) （2022KY707,2024KY866）
浙江省中医药科技计划项目(2024ZR048) （2024ZR048）
