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目的：研究脉压差等危险因素在中老年脑白质病变(WMLs)中的作用及临床意义。方法：入选213 例无神经病学症状及体征的中老年病人（年龄>50 岁），根据MRI 影像学诊断标准分为中重度WMLs 组（125 例）及轻无WMLs 组（88 例），通过回顾性分析，记录年龄、性别、高血压史、糖尿病史、吸烟史、脉压差、收缩压、舒张压、血脂水平、左房内径，比较两组间各项指标差异，并做 Binary Logistic 回归分析，筛选出WMLs 的独立危险因素。结果：在控制了高血压、年龄及其他混杂因素后，脉压差仍与WMLs 密切相关，且独立于年龄和高血压，是WMLs 的独立危险因素，OR 值为2.954，95%CI 1.032~8.453。结论：压差在预测中老年人亚临床脑血管事件中可能起到重要作用。

英文摘要:

Objective: To investigate the function and clinical value of pulse pressure and other risk factors in white matter lesions (WMLs) in elderly individuals. Methods: 213 elderly individuals （>50years）with no symptoms or signs of neurological manifestations were divided into the "advanced" WMLs group (125 cases) and the "little or no" WMLs group according to the MRI criterion. Age, sex, hypertension, diabetes, smoking, pulse pressure, systolic BP, diastolic BP, plasma lipid and left atrium diameter were recorded and were compared between the two groups. Independent risk factors of WMLs were obtained by the method of binary logistic analysis. Results: After controlling for hypertension, age and other confounders, pulse pressure was still significantly associated with WMLs. Pulse pressure was an independent risk factor of WMLs (OR 2.954,95%CI 1.032~8.453). Conclusion: Pulse Pressure may play an important role in predicting sub-clinical cerebrovascular events in elderly individuals.

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