脳の白質の損傷,網膜病変,およびインシデントの臨床脳卒中
Tien Yin Wong1, Ronald Klein, A Richey Sharrett
1Department of Ophthalmology, University of Wisconsin, Madison, USA. ophwty@nus.edu.sg
JAMA
|July 2, 2002
まとめ
網膜の異常に関連した白質病変 (WMLs) は,中年成人の脳卒中リスクを高めます. WMLと網膜病の早期発見は,臨床脳卒中の予測と予防に役立ちます.
科学分野:
- 神経学 神経学とは
- オフタルモロジック (眼科)
- 血管医学 血管医学とは
背景:
- 脳スキャンの白質病変 (WMLs) は,マイクロ血管の問題に起因し,脳卒中に先行すると疑われています.
- WMLsのマイクロ血管起源と脳卒中の予測値を確認するための限られた臨床データは存在します.
研究 の 目的:
- WMLs,網膜微血管の変化,および臨床脳卒中の発生率との関連を調査する.
- これらの関係を,健康な中年個人のコホートで分析する.
主な方法:
- Atherosclerosis Risk in Communities Study (ARIC) のデータを活用し,前向きな,人口ベースのコホートである.
- 脳のMRIと網膜写真撮影を受けた51歳から72歳の1684人の参加者を含む.
- MRIによるWMLと網膜の異常を評価し,中位 4.7 年の追跡期間中に発生した脳卒中と相関させました.
主要な成果:
- レチノパシーを持つ個人は,WMLの可能性が高いことを示しました (OR, 2.5).
- 5年間の脳卒中発生率は,WML (RR,3.4) と網膜病変 (RR,4.9) を有する患者で高かった.
- WMLと網膜病変の両方を有する個体では,どちらにもない個体と比較して,著しく高い脳卒中リスクが観察されました (RR, 18.1).
結論:
- 中年個人の脳性WMLは,網膜の微小血管異常と関連しています.
- WMLsの存在は,独立して臨床脳卒中のリスクを増加させます.
- 同時にWMLと網膜病気が併発すると,脳卒中のリスクが著しく上昇し,脳血管と網膜の健康との関連が強調されます.
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