| Introduction:With the development of society and the aging of the population,the importance of cerebral microbleeds(CMBs)has become increasingly prominent,which is a manifestation of cerebral small-vessel disease(CSVD).In the clinic,we often find the presence of CMBs in the head MRI in patients with ischemic stroke.Microalbuminuria(MAU)is a reaction index of vascular endothelial dysfunction,but there are few reports about the correlation between urinary microalbuminuria and cerebral microhemorrhage by monitoring acute ischemic stroke patients.This study aims to detect the relationship between changes in urine microalbumin levels in patients with ischemic stroke and cerebral microhemorrhage,including the correlation between the location and severity of cerebral microhemorrhage,and to provide a theoretical basis for clinical prevention and delay the occurrence and development of cerebral microhemorrhage.Methods:The clinical data of patients hospitalized with ischemic stroke in theneurology department of Liaoning Provincial People’s Hospital from September 2019 to January 2021 were collected.According to whether there are CMBs,they are divided into:CMBs positive group and CMBs negative group.The baseline data collected include:age,gender,body mass index,history of hypertension,history of diabetes,history of smoking,history of drinking,history of ischemic stroke,and history of drug use(including anticoagulation,antiplatelet,statins,etc.),History of coronary heart disease,history of atrial fibrillation.Related laboratory tests include triglycerides,total cholesterol,high-density lipoprotein,low-density lipoprotein,lipoprotein alpha,blood uric acid,homocysteine,blood urea nitrogen,creatinine,and urine microalbumin.The magnetic sensitivity sequence of head MRI was used to judge the location and quantity of CMBs,and the severity grouping and location grouping were performed according to the number and location of CMBs.Logistic multivariate regression analysis was performed using SPSS23.0 statistical software,and Spearman rank correlation analysis was used to explore the correlation between the level of urine microalbumin in patients with acute ischemic stroke and the presence,severity,and location distribution of cerebral microhemorrhage.Results:A total of 141 patients with acute ischemic stroke,aged 35-91 years,average age 70.26±10.39 years,average BMI 24.49±3.31kg/m~2,91 males(64.5%),50 females(35.5%);74 cases(52.5%)in the CMBs-positive group,67 cases(47.5%)in the CMBs-negative group;74 patients in the CMBs-positive group were 42-90 years old,with an average age of 71.30±9.93 years old,and an average BMI of 24.54±3.00kg/m~2,51 males(68.9%),33 cases of smoking history(44.6%),29 cases of drinking history(39.2%),66 cases of history of hypertension(89.2%),25 cases of history of diabetes(33.8%),There were 22 cases(29.7%)with a history of ischemic stroke,3 cases(4.1%)with a history of anticoagulant drugs,20 cases(27.0%)with a history of antiplatelet drugs,and 15 cases(20.3%)with a history of statins.21 cases(28.4%)with a history of coronary heart disease,13 cases(17.6%)with a history of atrial fibrillation;according to the location distribution of the CMBs positive group,they were divided into three groups:23 cases(31.1%)in the lobe group,23 cases in the deep/subtentorial group(31.1%),28 cases(37.8%)in the mixed site group;as stated or reported by the seriousness of the CMBs constructive group,they were arranged for three groups:42 example of case(56.8%)in the mild group,18 example of case(24.3%)Among them,14 cases were severe(18.9%).The CMBs negative group was 35-91 years old,with an average age of 69.10±10.84 years,an average BMI of 24.44±3.65kg/m2,40males(59.7%),26 smoking history(38.8%),and 17 alcohol drinking history(25.4%),61 cases(91.0%)with a history of hypertension,16 cases(23.9%)with a history of diabetes,11 cases(16.4%)with a history of ischemic stroke,0 cases(0.0%)with a history of anticoagulant drugs,antiplatelet There were 20 cases(29.9%)with a history of drug use,15 cases(22.4%)with a history of statin use,10 cases(14.9%)with a history of coronary heart disease,and 0 cases(0.0%)with a history of atrial fibrillation.The results of univariate analysis showed that compared with the CMBs-negative group,the composition ratio of the history of hypertension,the history of diabetes,the composition of atrial fibrillation,the BUN level,the MAU level,and the fazekas score were different in the CMBs positive group and the CMBs negative group.The difference was statistically significant(P<0.05).The proportion of CMBs positive group with a history of hypertension(89.2%),history of diabetes(33.8%),history of atrial fibrillation(17.6%),BUN level[M(p25,p75)=5.96(4.44,7.40)mmol/L],MAU Level[M(p25,p75)=35.5(15.5,90.0)mg/L],Fazekas score[M(p25,p75)=4(2,5)].The CMBs positive group was divided into three groups according to the number:fazekas score:mild group[M(p25,p75)=2(2,4)]<moderate group[M(p25,p75)=3(3.5,6)]<Severe group[M(p25,p75)=6(5,6)],the difference between groups was statistically significant(P<0.05).The CMBs positive group was divided into three groups according to the location distribution:fazekas score:lobe group[M(p25,p75)=2(2,4)]<deep/subtentorial group[M(p25,p75)=4(2,4)]<mix In the location group[M(p25,p75)=5.5(4,6)],the difference between the groups was statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that after proofreading other confounding factors,MAU level(OR=1.025,95%CI=0.9491.010-1.039,P=0.001),history of hypertension(OR=7.059,95%CI=2.297-21.701,P=0.001),history of diabetes(OR=5.493,95%CI=2.217-13.609,P=0.000),fazekas score(OR=3.293,95%CI=2.202-4.924,P=0.000)are independent CMBs Risk factors.Spearman rank correlation analysis shows that MAU level has a weak positive correlation with the occurrence of CMBs(r=0.268,P=0.02),fazekas score has a weak positive correlation with the occurrence of CMBs,and the difference between fazekas score and CMBs is significant.There is a weak positive correlation between the degree and the location of the disease.Conclusion:1.Hypertension and diabetes are independent risk factors for the occurrence of CMBs in patients with ischemic stroke.2.Leukopenia is an independent risk factor for the onset of CMBs in patients with ischemic stroke.The higher the fazekas score,the greater the number of CMBs,and the fazekas score is related to the location of CMBs.3.As a risk factor of CMBS in patients with acute ischemic stroke,Mau level is independent.With the increase of Mau level,the incidence and risk of CMBS also increased. |
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