| Objective: Leukoaraiosis(LA)is a common degeneration of the nervous system with mild clinical manifestations.A large number of literatures have shown that it is closely related to cerebrovascular diseases.As a kind of cerebrovascular disease with high disability rate and mortality,spontaneous intracerebral hemorrhage(SICH)is worth extensive attention.Hematoma volume is the key factor influencing the prognosis of ICH,currently on the conclusions of research between the severity of LA and hematoma volume is not consistent and controversial,and on the relationship between the LA lesion and the volume is unclear,so the purpose of this study is to explore whether the severity and lesion of LA are related to hematoma volume.Methods: A total of 109 patients with ICH admitted to the Department of Neurology,the First Affiliated Hospital of China Medical University from August 2018 to December 2020 were retrospectively analyzed.The brain CT of the patients within 12 hours of onset was collected,and the volume of ICH was calculated by Tata formula[1].Blennow scale was used to score the severity of LA on the basis of cranial CT.Meanwhile,general information,laboratory examination and imaging examination were collected.(1)109 patients were divided into three groups according to Blennow score,and the differences in a series of clinical,laboratory and imaging data variables such as age,gender,blood pressure and blood glucose among each group were analyzed.(2)According to the volume,the patients were divided into small volume group(≤10ml),medium volume group(11m L-20ml)and large volume group(≥21ml),and the relationship between the volume and Blennow score and LA lesions was respectively analyzed.The single factor(p<0.05)were included to Logistic multivariate regression model to determine whether the severity and lesion of LA were independently related to the hematoma volume.Results: 1.A total of 109 patients with SICH were included in this study,among which 79 cases(72.5%)were LA.2.Patients were divided into three groups according to the Blennow score.Compared with baseline data,it was found that the severe LA had higher age,SBP,and hematoma volume(P=0.000,0.003,0.004)compared with mild OR none of LA,while there were no significant differences in past history,laboratory data,and site of ICH.3.According to the hematoma volume,the patients were divided into three groups: small volume group(≤10ml),medium volume group(11m L-20ml)and large volume group(≥21ml).It was found that there were statistically significant differences in GCS,Blennow score,SBP and LA lesions among the three groups(P=0.000,0.023,0.000,0.000),that is,the group with larger hematoma had higher GCS,LA severity and SBP.Moreover,the group with larger hematoma was more likely to be associated with periventricular and subcortical LA.4.The single factor associated with hematoma volume(P<0.05):Multivariate analysis showed that GCS(OR=0.774,95%CI 0.607-0.988,P=.040),SBP(OR=1.064,95%CI 1.009-1.102,P=.019),mild LA(OR=1.305,95%CI 1.074-2.683,P=.046),severe LA(OR=2.960,95%CI 2.119-3.353,P=.000),periventricular subcortical LA(OR=2.010,95%CI 1.905-2.307,P=.007)was independently associated with hematoma volume.Conclusions: Age and SBP have a close influence on LA,and the volume of cerebral hemorrhage is closely related to GCS,the severity of LA,SBP and lesion site of LA.Patients with severe LA are more likely to have a larger hematoma volume,as are patients with periventricular complicated subcortical LA.Strictly controlling SBP,early detection,diagnosis and intervention of LA are of great significance for the prognosis of ICH patients. |
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