Leukoaraiosis in Normotensive Patients to Assay Factors Other than Hypertension

正常血壓病人之大腦小血管缺血性疾病危險因子之評估

邱振輝(Cheng-Hui Chiu) ； 張寶源(Pau-Yang Chang) ； 周紹賓(Andy Shau-Bin Chou) ； 黃信文(Hsin-Wen Huang) ； 李世傑(Sea-Kiat Lee) ； 林昭君(Chau-Chin Lin) ； 凌昌明(Chang-Ming Ling) ； 嚴寶勝(Pao-Sheng Yen) ； 李超群(Chau-Chin Lee)

《中華放射線醫學雜誌》 31卷2期 (2006/04) Pp. 71-75

摘要

腦白質小病灶(Leukoaraiosis)在神經影像學上被認為是中風的一個危險因子並且與高血壓有相關性；本實驗的目的在評估除了高血壓外，有哪些因子與腦白質小病灶相關。在2000年九月至2004年六月間，共45位正常血壓之病人（收縮壓低於100毫米汞柱以及/或舒張壓低於60毫米汞柱）。回溯性收集這些病人之年齡、性別以及實驗室資料包括血小板數目、紅血球沉降速率、肌酸酐、尿酸、乳酸脫氫、高密度膽固醇、低密度膽固醇、三酸甘油酯、總膽固醇、以及空腹血糖。並非每位病人都能收集到完整的資料。有6位男性病人以及39位女性被納入這個實驗；年齡分布從22歲至72歲，平均為52±11歲。34位(77%)小於60歲。22位病人有正常血清濃度的肌酸酐以及19位病人有正常血清濃度的尿酸。20位病人中有7位(35%)的三酸甘油酯上升超過正常值。20位病人中的6位(30%)有升高的總膽固醇濃度。只有一位病人有高血醣。11位病人中有9位(82%)有紅血球沉降率升高的現象。
過去的研究中認為高血壓以及高血脂是與腦白質小病灶相關的主要因子。但是在我們的實驗中發現在正常血壓的病人中，腦白質小病灶是與女性以及比較年輕（小於60歲）以及紅血球沉降率升高有關聯。

關鍵字

高血壓 ； 腦白質小病變 ； 核磁共振造影

並列摘要

To evaluate factors other than hypertension that may be related to leukoaraiosis (LA), a neuroimaging finding and risk factor for stroke thought to be related to high blood pressure.
From September 2000 to June 2004, we enrolled 45 normotensive patients (systolic BP less than 100 mm Hg and/or diastolic BP less than 60 mm Hg) with LA changes on MR imaging. We retrospectively reviewed their age, sex, and laboratory data (platelet count, erythrocyte sedimentation rate, and creatinine, uric acid, lactate dehydrogenase, highdensity lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, total cholesterol, and fasting glucose levels). Not all variable laboratory data were available for all patients. Among the 45 patients, six patients (13%) were men and 39 were women (87%). Their age ranged from 22 to 72 years, with mean ±SD of 52 years ±11. Thirtyfour patients (77%) were younger than 60 years. Twenty-two patients had normal creatinine and nineteen patients had normal uric acid levels. Seven (35%) of twenty patients had elevated (＞130 mg/dL) triglyceride levels. Six (30%) of twenty patients had elevated total cholesterol concentrations, and only one patient had hyperglycemia. Nine (82%) of 11 patients had an elevated (＞10 mm/h) erythrocyte sedimentation rate.
Arterial hypertension and hyperlipidemia were expected to be the main factor associated with LA. However, in normotensive patients, LA predominated in women and in younger (＜60 years) patients, and was associated with an elevated erythrocyte sedimentation rate.

並列關鍵字

Hypertension ； Leukoaraiosis ； Magnetic Resonance Imaging MRI