Risk Factors For Congitive Dysfunction In Patients Suffering From Cerebral White Matter Lesions Combined With Carotid Artery Stenosis

Background and Objective: Cerebral white matter lesions(white matter lesions,WML),also known as leukoaraiosis,proposed by the Canadian neurologist Hachinski,etc.firstly,usually refers to the punctate or patchy abnormal signals that appear in the white matter in the deep and lateral cerebral ventricle.At present,the pathogenesis of white matter lesions is not completely clear,and many scholars believe that it is caused by chronic cerebral ischemia caused by vasogenic edema,microvascular and/or endothelial dysfunction.White matter damage can disrupt signal transmission between neurons,between the cortex and the subcortical center,leading to cognitive dysfunction and gait abnormalities that eventually lead to persistent or progressive cognitive and neurological dysfunction.Pantoni concluded that several studies have suggested that WML is associated with cognitive impairment and WML plays a role in cognitive impairment.Carotid stenosis not only means intracranial or systemic atherosclerosis,but may also be a direct cause of cognitive impairment.There are also indications that in some parts of the western world,the prevalence of cognitive decline may be reduced,and worryingly,the prevalence of cognitive impairment in Asia may be increasing.This study analyzed the risk factors associated with cognitive dysfunction in patients with white matter lesions and carotid stenosis,and hoped to provide scientific basis for the diagnosis and treatment of white matter lesions with carotid stenosis.Methods: 187 inpatients from Dec.2016 to Oct.2017 with cerebral white matter lesions were enrolled into our study that divided into two groups(with and without carotid artery stenosis).Incidence of carotid artery stenosis were evaluated.And investigating the risk factors for the cognitive dysfunction in patients suffering from of cerebral white matter lesions combined with carotid artery stenosis.Logistic regressions were applied to analyze related independent influencing factors.Results: The incidence of carotid stenosis was 47.59% in patients with cerebral white matter lesions.There was a correlation between cerebral white matter lesions and carotid stenosis.The results of Mo CA score in patients with carotid stenosis group(21.02 + + 2.33)were significantly lower than those in the non-carotid artery stenosis group(23.43 + 2.63),and the difference was statistically significant(P < 0.01).Mo CA scores in patients with moderate and severe carotid artery stenosis were significantly lower than those in patients with mild carotid artery stenosis(P < 0.05,P < 0.01).Logistic regression analysis indentified advanced age(OR=1.332,95%CI 1.194-1.485,P<0.001),smoking history(OR=1.396,95%CI 0.328-5.944,P<0.01),History of alcohol intake(OR=0.251,95%CI 0.05-1.252,P<0.05),c-reactive protein(OR=1.414,95%CI 0.883-2.264,P<0.05)as being significantly and independently associated with cognitive dysfunction in patients with cerebral white matter lesions and carotid artery stenosis.Conclusion: There is a correlation between the degree of white matter lesions and the degree of carotid stenosis.The more severe the degree of carotid stenosis in patients with cognitive decline more obvious.Age,smoking history,History of alcohol intake and c-reactive protein as being significantly and independently associated with cognitive dysfunction in patients with cerebral white matter lesions and carotid artery stenosis.