Analysis Of Related Risk Factors And Imaging Features In Middle-aged And Elderly Patients With Lacunar Infarction

Objective By analyzing the relevant risk factors and imaging(MRI,TCD,carotid ultrasound)features of middle-aged and elderly patients with lacunar infarction,to further help patients to strengthen their comprehensive and in-depth understanding of the disease,and attach importance to early effective treatment and secondary prevention of the disease.Methods 90 patients with lacunar infarction treated in the neurological ward of Liyuan Hospital from September 2017 to September 2019 were selected as the case group,and 90 patients with non-lacunar infarction during the same period in the inpatient ward were selected as the control group.The case-control study method was used to screen for significant risk factors by single factor analysis,and then using multi-factor logistic regression to analyze the relationship between each risk factor and the risk of lacunar infarction.To analyze and compare the results of head MRI,TCD,and carotid ultrasound.Results 1.Basic situation: the research objects are mainly middle-aged and elderly,most cases in the case group are between 65-74 years old,lacunar infarction over 65 years of age has a higher incidence,with a total of 67 people,accounting for 74.44% of the total.2.Related risk factors: hypertension(OR = 9.036,P <0.01),diabetes(OR = 3.380,P <0.01),coronary heart disease(OR = 2.207,P <0.05),smoking history(OR = 1.942,P <0.05),obesity(OR = 2.564,P <0.05),low-high density lipoprotein(OR = 3.090,P <0.01),and high homocysteine(OR = 2.943,P <0.01).Among the risk factors,hypertension was suggested as the most important independent risk factor for lacunar infarction(OR = 9.036).3.Analysis of imaging characteristics: MRI results show that the lacunar lesions are distributed in the order of the basal ganglia,the radiating crown,the frontal lobe,the thalamus,the parietal lobe,the semioval center,the temporal lobe,the inner capsule,the brain stem,and the cerebellum.Among them,the basal ganglia area is the main area,and lacunar lesions are usually multiple,with 2-4 sites being common,and single lesions are rare.TCD results showed that the abnormal blood flow rate in the case group was significantly higher than that in the control group.The blood vessels with higher abnormal rates in the case group were the anterior cerebral artery and middle cerebral artery,which may be related to the blood supply area of the brain.The results of carotid ultrasound showed that the detection rate of carotid plaque in the case group was also significantly higher than that in the control group.Conclusions 1.The age of onset of lacunar infarction in middle-aged and elderly people is mostly over 65 years.2.LI is a multi-risk disease,hypertension,diabetes,coronary heart disease,smoking history,obesity,low-high density lipoprotein,and high homocysteine are risk factors for LI.Among them,hypertension is the most important risk factor that should be intervened first.3.MRI is the preferred imaging method for diagnosis of LI.MRI results show that lacunar lesions are mostly distributed in basal ganglia,radiation crown,frontal lobe,thalamus and other parts.4.TCD can monitor the hemodynamic changes of intracranial arteries in real time,carotid ultrasound can detect the presence of vascular stenosis and plaque in the middle-aged and elderly population,providing clinical evidence for the prevention and early intervention of LI.Both are clinically simple,non-invasive and irreplaceable examination methods for LI patients.