脑小血管疾病患者脑白质高信号进展危险因素分析OA

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.