攀枝花地区中老年脑小血管病患者心血管健康行为与疾病总负荷关联研究

doi:10.12183/j.scjpm.2026.0684

摘要/Abstract

摘要： 目的探讨攀枝花地区中老年脑小血管病（CSVD）患者心血管健康行为与疾病总负荷的关联。方法选取2024年1月至2025年12月攀枝花第二人民医院神经内科门诊随访的稳定性中老年CSVD患者作为研究对象,均行头颅磁共振扫描,评估总负荷得分,根据总负荷得分分为轻中负荷组（0~2分）和重度负荷组（3~4分）。所有患者均进行心血管健康（CVH）评分评估,采用多因素logistic回归模型评估CVH评分与中老年CSVD患者总负荷风险的关联。结果本研究最终纳入826例中老年CSVD患者,其中轻中度负荷组506例,重度负荷组320例。校正年龄、冠心病史、脑卒中史等混杂因素后进行logistic回归分析,结果显示吸烟状况（OR=0.368）、睡眠质量（OR=0.298）、血脂水平（OR=0.256）、血糖水平（OR=0.375）、血压控制情况（OR=0.279）与中老年CSVD患者总负荷相关;相较于低CVH亚组,中、高CVH亚组发生重度负荷的风险均显著降低;随CVH评分升高重度负荷的发生风险逐渐降低（趋势检验P<0.01）。结论攀枝花地区中老年CSVD患者CVH评分与总负荷呈负相关,CVH评分越低,总负荷水平越高,CVH评分是CSVD总负荷的独立影响因素,提示维持良好心血管健康有利于降低CSVD总负荷。

关键词: 中老年, 脑小血管病, 总负荷, 心血管健康评分

Abstract: Objective To investigate the association between cardiovascular health (CVH) behaviors and the total burden of cerebral small vessel disease (CSVD) in middle-aged and elderly patients in the Panzhihua region. Methods A cohort of stable middle-aged and elderly patients with CSVD, who were followed up at the neurology outpatient clinic of Panzhihua Second People's Hospital between January 2024 and December 2025, was selected for this study. All participants underwent cranial magnetic resonance imaging to assess the total CSVD burden score. Based on this score, patients were categorized into a low-to-moderate burden group (0-2 points) and a severe burden group (3-4 points). Cardiovascular Health (CVH) scores were evaluated for all participants. A multivariate logistic regression model was employed to analyze the association between CVH scores and the risk of total CSVD burden in this patient population. Results The final analysis included 826 middle-aged and elderly patients with CSVD, of whom 506 were in the low-to-moderate burden group and 320 were in the severe burden group. After adjusting for confounding factors such as age, history of coronary heart disease, and history of stroke, logistic regression analysis revealed that smoking status (OR=0.368), sleep quality (OR=0.298), lipid levels (OR=0.256), blood glucose levels (OR=0.375), and blood pressure control (OR=0.279) were significantly associated with the total CSVD burden. Compared to the low CVH subgroup, the risks of severe CSVD burden were substantially lower in the medium and high CVH subgroups. Furthermore, a trend test indicated that as the CVH score increased, the risk of severe CSVD burden progressively decreased (P for trend <0.01). Conclusion In the middle-aged and elderly CSVD population of the Panzhihua region, there is a negative correlation between the CVH score and the total CSVD burden. A lower CVH score is associated with a higher total burden of the disease, suggesting that the CVH score is an independent factor influencing the total CSVD burden. These findings indicate that maintaining good cardiovascular health is beneficial for reducing the total burden of CSVD.

Key words: Middle-aged and elderly, Cerebral small vessel disease, Total burden, Cardiovascular health score

中图分类号:

R743

柘晓宁, 龙晓艳, 汤利, 唐光情, 钱敏, 于海东. 攀枝花地区中老年脑小血管病患者心血管健康行为与疾病总负荷关联研究[J]. 华南预防医学, 2026, 52(6): 684-689.

Zhe Xiaoning, Long Xiaoyan, Tang Li, Tang Guangqing, Qian Min, Yu Haidong. Association of cardiovascular health behaviors with total disease burden in middle-aged and elderly patients with cerebral small vessel disease in Panzhihua[J]. South China Journal of Preventive Medicine, 2026, 52(6): 684-689.

参考文献

[1] Chojdak-Łukasiewicz J, Dziadkowiak E, Zimny A, et al. Cerebral small vessel disease: A review[J]. Adv Clin Exp Med, 2021, 30(3): 349-356.
[2] Zhang L, Gao F, Zhang Y, et al.Analysis of risk factors for the development of cognitive dysfunction in patients with cerebral small vessel disease and the construction of a predictive model[J]. Front Neurol, 2022, 13(1): 944205.
[3] Lloyd-Jones DM, Hong Y, Labarthe D, et al.Defining and setting national goals for cardiovascular health promotion and disease reduction: The American Heart Association's strategic Impact Goal through 2020 and beyond[J]. Circulation, 2010, 121(4): 586-613.
[4] 尤晶, 李理, 骆嵩. 高危非致残性缺血性脑血管事件与脑小血管病影像学总负荷的相关性分析[J]. 实用临床医药杂志, 2025, 29(21): 19-23.
[5] Ekenze O, Pinheiro A, Beiser AS, et al.Prevalent cardiovascular disease and atrial fibrillation in relation to cerebral small vessel disease burden[J]. Brain Sci, 2025, 15(8): 813.
[6] 攀枝花市统计局, 攀枝花市第七次全国人口普查领导小组办公室. 攀枝花市第七次全国人口普查公报(第四号)[N]. 攀枝花日报, 2021-06-01(003).
[7] 张群, 王光丽, 陈跃芳, 等. 四川省攀枝花市东区成年居民慢性病患病情况调查[J]. 中国健康教育, 2018, 34(5): 432-436.
[8] 中国研究型医院学会脑小血管病专业委员会《中国脑小血管病诊治专家共识》编写组. 中国脑小血管病诊治专家共识2021[J]. 中国卒中杂志, 2021, 16(7): 716-726.
[9] Lloyd-Jones DM, Allen NB, Anderson CAM, et al.Life's Essential 8: Updating and enhancing the American Heart Association's Construct of Cardiovascular Health: A presidential advisory from the American Heart Association[J]. Circulation, 2022, 146(5): e18-e43.
[10] Silva GD, Telles JPM, Rimkus CM, et al.Reliability and validity of the total cerebral small vessel disease score: A systematic review and meta-analysis[J]. Front Neurol, 2025, 16(1): 1593402.
[11] Yuan Y, Tian P, Li L, et al.Comparison of the associations between life's essential 8 and life's simple 7 with stroke: NHANES 1999-2018[J]. J Stroke Cerebrovasc Dis, 2025, 34(3): 108238.
[12] Yan B, Jin Y, Mao S, et al.Association of Life's essential 8 score with the risk of all-cause mortality and cardio-cerebrovascular mortality in patients with stroke[J]. BMC Cardiovasc Disord, 2024, 24(1): 320.
[13] Acosta JN, Both CP, Rivier C, et al.Analysis of clinical traits associated with cardiovascular health, genomic profiles, and neuroimaging markers of brain health in adults without stroke or dementia[J]. JAMA Netw Open, 2022, 5(5): e2215328.
[14] Shi H, Cui L, Hui Y, et al.Sustained high Life's Essential 8 is associated with lower risk of cerebral small vessel disease: A community-based study[J]. Front Neurol, 2025, 16: 1563288.
[15] Fongang B, Satizabal C, Kautz TF, et al.Cerebral small vessel disease burden is associated with decreased abundance of gut Barnesiella intestinihominis bacterium in the Framingham Heart Study[J]. Sci Rep, 2023, 13(1): 13622.
[16] 李晓艳, 季洪革, 王婷婷, 等. 基于β2-微球蛋白和脂蛋白a的脑小血管病MRI总负荷预测模型构建[J]. 中国临床医学, 2025, 32(4): 634-641.
[17] Yan Y, Cheng Y, Jiang S, et al.Acute cerebral small vessel disease: Classification, mechanism, and therapeutic implications[J]. Chin Med J (Engl), 2024, 137(21): 2561-2563.
[18] Koohi F, Harshfield EL, Gill D, et al.Optimizing treatment of cardiovascular risk factors in cerebral small vessel disease using genetics[J]. Brain, 2025, 148(6): 1936-1949.
[19] Wu WW, Wang Y, Xu J, et al.Explore the correlation between cerebral vessel characteristics with cognitive impairment among elder individuals: A community study from China[J]. BMC Neurol, 2021, 21(1): 484.
[20] 李杰, 贾林燚, 高凤霄, 等. 脑小血管病MRI总负荷与老年高血压群体认知功能障碍的相关性分析[J]. 中国神经精神疾病杂志, 2025, 51(1): 15-19.
[21] 周祁惠, 杨磊, 胡文立. 非高密度脂蛋白胆固醇与脑小血管病影像总负荷的相关性研究[J]. 中华老年心脑血管病杂志, 2025, 27(1): 76-79.
[22] Kim J, Yoon DW, Myoung S, et al.Coexistence of moderate-to-severe obstructive sleep apnea and inflammation accelerates the risk of progression of arterial stiffness: A prospective 6-year study[J]. Life (Basel), 2022, 12(11): 1823.
[23] Kim SH, Shin C, Kim S, et al.Prevalence of isolated nocturnal hypertension and development of arterial stiffness, left ventricular hypertrophy, and silent cerebrovascular lesions: The KoGES (Korean Genome and Epidemiology Study)[J]. J Am Heart Assoc, 2022, 11(19): e025641.
[24] Trifan G, Stickel AM, Cai J, et al.Association of cardiovascular health with brain volume and white matter integrity: Results of the SOL-INCA MRI Study[J]. Neurology, 2025, 104(8): e213404.
[25] Ahmed S, Bosotov D, Noor MM, et al.Predictors of stroke recurrence and outcomes in cerebral small vessel disease: A systematic review of the secondary prevention of Small Subcortical Strokes (SPS3) Trial Findings[J]. Cureus, 2025, 17(3): e81393.