Risk Factors Of Enlarged Perivascular Space In Patients With Ischemic Stroke And Its Correlation With Post-stroke Cognitive Impairment

Objectives 1 To investigate the distribution and incidence of enlarged perivascular space(EPVS)in patients with ischemic stroke;2 To explore the factors affecting the severity of EPVS at different locations in patients with ischemic stroke;3 Explore the risk factors of cognitive function in patients with ischemic stroke.Methods 1 Select 440 patients with ischemic stroke who were hospitalized in the Department of Neurology of Hebei General Hospital from January 2018 to December2019 and met the criteria for intake and discharge,respectively evaluate the basal ganglia(BG),centrum semiovale(CSO),midbrain and hippocampal EPVS,discusses the distribution and incidence of EPVS in patients with ischemic stroke.According to the severity of EPVS,BG-EPVS/CSO-EPVS were divided into mild group and moderate to severe group,midbrain EPVS was divided into EPVS with and without EPVS group,and hippocampal EPVS was divided into mild and severe group,so as to explore the risk factors of EPVS severity in different locations.2 Select 236 patients with ischemic stroke who completed the cognitive function scale assessment within 6 months after stroke,on the basis of the Montreal Cognitive Assessment(Mo CA)score as a result,the enrolled patients were divided into post-stroke cognitive impairment group and cognitive normal group,to explore the influence factors of cognitive function after stroke in patients with ischemic stroke.Results 1 The incidence of EPVS in different locations were: 435 cases(98.9%)of BGEPVS,including 201 cases of mild and 239 cases of moderate to severe;434 cases of CSO-EPVS(98.6%),including 155 cases of mild and 285 cases of moderate to severe Cases;midbrain EPVS 232 cases(52.7%);hippocampal EPVS 365 cases(83.0%),of which 246 cases were mild and 194 cases were severe.2 Analysis of the factors influencing the severity of EPVS in different brain locations showed that:(1)Cerebral microbleeds(OR=1.809,95%CI: 1.093-2.994,P<0.05),Periventricular white matter hyperintensity(OR=3.023,95%CI: 1.543-5.922,P<0.05)was an independent risk factor for the severity of BG-EPVS;(2)Lacunar infarctions was associated with BG-EPVS(OR=3.129,95%CI: 1.891-5.177,P<0.05),CSO-EPVS(OR=1.904,95%CI: 1.213-2.991,P<0.05),hippocampal EPVS(OR=1.568,95%CI: 1.009-2.436,P<0.05)independent risk factors for severity;3 The analysis of factors affecting cognitive function after stroke showed that different grades of BG-EPVS(OR=1.583,95%CI: 1.146-2.186,P<0.05),gender(OR=2.437,95%CI: 1.059-5.611,P<0.05)is an independent risk factor for cognitive impairment after stroke.4 Different levels of BG-EPVS was negatively correlated with the total MMSE score,total Mo CA score,visual space ability,language ability,and memory ability,among which the total Mo CA score(r=-0.206,P<0.05),memory ability(r=-0.242,P<0.001)were stronger.Conclusions 1 EPVS is common in patients with ischemic stroke,and the incidence of BG/CSO-EPVS is relatively high and more serious.2 The severity of BG-EPVS was more severe in ischemic stroke patients with cerebral microbleeds and severe periventricular white matter hyperintensity.Patients with lacunar infarctions have more severe BG-EPVS,CSO-EPVS,and hippocampal EPVS.3 The incidence of PSCI is relatively high in patients with ischemic stroke,and it is one of the common complications of stroke.4 Female patients and patients with ischemic stroke with higher BG-EPVS grade were more likely to develop PSCI.5 BG-EPVS is negatively correlated with cognitive function after ischemic stroke.The higher the grade of BG-EPVS,the more severe the impairment of cognitive domains such as visual space ability,language ability,and memory ability.Figure 0;Table 13;Reference 168...