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目的:探讨脑微出血(cerebral microbleeds, CMBs)部位及体积与脑小血管病(cerebral small vessel disease, CSVD)患者腔隙性脑梗死(lacunar infarction, LI)的相关性。方法:回顾性纳入2017年2月至2019年3月期间南京大学医学院附属鼓楼医院CSVD队列中的受试者。所有受试者均接受MRI扫描以及标准化临床评估和诊断，采用香港中文大学开发的自动分割和量化大脑软件AccuBrain对CMBs和脑白质高信号(white matter hyperintensities, WMHs)体积进行定量分析。应用有序多分类n logistic回归分析确定LI的独立影响因素，然后进一步应用多元线性回归分析探讨深部和幕下微出血(deep or infratentorial CMBs, DI-CMBs)体积与LI数量的相关性。n 结果:共有317例CSVD患者纳入分析，其中无LI组214例(67.5%)，单发性LI组43例(13.6%)，多发性LIs组60例(18.9%)。三组间比较显示，年龄较大、男性、吸烟、饮酒、既往卒中或短暂性脑缺血发作(transient ischemic attack, TIA)史、高密度脂蛋白胆固醇水平较低、CMBs及WMHs体积较大、血管周围间隙扩大(enlarged perivascular spaces, EPVS)分级较高可能是LI的危险因素。有序多分类n logistic回归分析显示，男性(优势比2.058，95%置信区间1.084～3.909；n P＝0.027)、既往卒中或TIA史(优势比1.962，95%置信区间1.089～3.535；n P＝0.025)、WMHs体积较大(优势比8.716，95%置信区间4.034～18.832；n P<0.001)、EPVS分级较高(优势比1.915，95%置信区间1.292～2.839；n P＝0.001)、DI-CMBs体积较大(优势比1.022，95%置信区间1.006～1.038；n P＝0.008)或个数较多(优势比1.187，95%置信区间1.005～1.403；n P＝0.044)为LI的独立相关因素。多元线性回归分析表明，DI-CMBs体积与LI数量之间存在显著相关性(n r＝0.330，n P<0.001)。n 结论:在CSVD患者中，DI-CMBs与LI之间存在显著相关性。“,”Objective:To investigate the correlation between the location and volume of cerebral microbleeds (CMBs) and lacunar infarction (LI) in patients with cerebral small vessel disease (CSVD).Methods:Participants from the CSVD cohort in the Department of Neurology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University from February 2017 to March 2019 were enrolled retrospectively. All participants underwent magnetic resonance imaging scans, standardized clinical assessment and diagnosis. AccuBrain, an automatic brain segmentation and quantification software developed by the Chinese University of Hong Kong, was used to quantitatively analyze the volume of CMBs and white matter hyperintensities (WMHs). Ordered multi-class n logistic regression analysis was used to determine the independent influencing factors of LI, and then multiple linear regression analysis was used to investigate the correlation between the volume of deep or infratentorial CMBs (DI-CMBs) and the number of LI.n Results:A total of 317 patients with CSVD were included in the analysis, including 214 (67.5%) in the non-LI group, 43 (13.6%) in the single LI group, and 60 (18.9%) in the multiple LI group. The comparison of the three groups showed that older age, male, smoking, drinking, history of previous stroke or transient ischemic attack (TIA), lower levels of high-density lipoprotein cholesterol, larger CMBs and WMHs volume, higher enlarged perivascular spaces (EPVS) grade might be the risk factors for LI. Ordinal multivariable n logistic regression analysis showed that male (odds ratio [n OR] 2.058, 95% confidence interval [n CI] 1.084-3.909; n P=0.027), previous stroke or TIA history (n OR 1.962, 95% n CI 1.089-3.535; n P=0.025), larger WMH volume (n OR 8.716, 95% n CI 4.034-18.832; n P<0.001), higher EPVS grade (n OR 1.915, 95% n CI 1.292-2.839; n P=0.001), larger DI-CMB volume (n OR 1.022, 95% n CI 1.006-1.038; n P=0.008) or more DI-CMB number (n OR 1.187, 95% n CI 1.005-1.403; n P=0.044) were the independent related factors of LI. Multiple linear regression analysis showed that there was a significant correlation between the volume of DI-CMB and the number of LI (n r=0.330, n P<0.001).n Conclusion:In patients with CSVD, there is a significant correlation between DI-CMBs and LI.