The Correlation Of Coagulation-Fibrinolysis System And Cerebral White Matter Lesions And Its Syndrome Elements

OBJECTIVE:we explore the risk factors and fibrinolysis coagulateon markers about WMLs,while exploring and analyzing the distribution of TCM syndromes of WMLs.METHODS:we collected clinical data of 192 patients from Department of Neurology,Affiliated Hospital of Chengdu university of Traditional Chinese Medicine from June 2019 to January2021.The risk factors of WMLs were investigated by Logistic regression analysis.The severity of WMLs was divided into groups based on the Fazekas scale,and the difference of risk factors among subgroups was investigated.To explore the correlation between WMLs and TCM syndromes distribution.Based on SPSS 23.0 software,the data were analyzed statistically.RESULTS: We enrolled 132 patients with WMLs and 59 patients without it in this study.(1)Comparing baseline data between the two groups,logistic regression analysis showed age(OR1.241,95%Cl 1.140-1.350,p=0.000),hypertension(OR 7.736,95%Cl 12.678-22.347,p=0.000),lipoprotein a(OR 1.003,95% Cl 1.000-1.006 p=0.033)may be an independent risk factor for WMLs;(2)Accroding to the severity of WMLs,the result shows that smoking history(p=0.017),drinking history(p=0.039),cystatin C(p=0.030),uric acid(p=0.021)may be related to the severity of WMLs;(3)There are statistical differences in fibrinogen(p=0.003)and fibrin degradation products(p=0.012)about coagulation and fibrinolysis related indicators between the two groups,but we did not find that them were the blood independent risk factors about WMLs by Logistic regression analysis,;(4)We found fibrinogen(p=0.005)is correlated with the severity of white matter lesions;(5)We did not find the correlation between D-dimer and vasogenic white matter lesions.(6)About the distribution of TCM syndromes of WMLs,Phlegm-dampness syndrome accounts for the largest proportion,followed by Qi-deficiency syndrome and internal fire syndrome,followed by Yin-deficiency syndrome,blood stasis syndrome,and internal fire phlegm.The smallest proportion of dampness syndrome is Qi deficiency and blood stasis syndrome and internal fire and blood stasis syndrome.CONCLUSION:(1)In this study,age hypertension and lipoprotein A were are independent risk factors for WMLs.Smoking,drinking,uric acid and cystatin C levels may be correlated with the severity of WMLs.(2).The fibrinogen level may be correlated with the severity of WMLs.(3)This study found that the TCM syndromes in WMLs group accounted for the largest proportion of phlegm and dampness,followed by Qi deficiency and internal fire,and the least were Qi deficiency and internal fire and blood stasis syndromes.