| BackgroundCerebral small vessel disease（CSVD）refers to a series of clinical,imaging and pathological syndromes caused by intracranial arterioles,microarteries,capillaries,venules and lesions caused by various causes.It can cause 25%stroke and 45%dementia,and the diagnosis mainly depends on imaging findings.Image-based CSVD total burden has become a widely accepted method to comprehensively evaluate the severity of CSVD.The pathogenesis of CSVD is still unclear,and inflammation may play an important role in a variety of pathogenesis.Studies have shown that the inflammatory index interleukin-6（IL-6）is closely related to the occurrence and development of CSVD.At present,studies tend to regard small vessel disease as a systemic disease.Cerebral small vessels and renal arterioles have similar anatomical structure and physiological characteristics.When the body is exposed to various risk factors,both renal small vessels and cerebral small vessels will be damaged.Urinary microalbumin/urinary creatinine（ACR）is a sensitive indicator of renal function damage,and many studies have found that ACR is related to CSVD.Objective1.The correlation between IL-6,ACR and the total burden of CSVD was discussed respectively.2.Looking for biochemical indexes that can be used to predict the total burden of CSVD economically.Method1.A total of 80 CSVD patients who were hospitalized in the Department of Neurology of Kaifeng Central Hospital from January 2021 to December 2021 were prospectively included in the study.2.All patients were assessed CSVD burden and calculated CSVD total burden score according to MRI.According to the score,they were divided into two groups:low burden group（0:2）and high burden group（3:4）.The levels of IL-6 and ACR were measured and other related clinical data were recorded.3.Using SPSS 23.0 statistical software,independent sample t-test was used to measure data,χ~2test was used to count data,binary logistic regression analysis was used to find out the risk factors of increased CSVD imaging burden,and subjects’Receiver Operating Characteristic（ROC）curve was drawn to understand the predictive value of IL-6 and ACR on CSVD high burden.Results1.There were 80 patients in the group,49 patients in the low burden group and 31patients in the high burden group.2.Compared with the low burden group,the age of the high burden group was higher,and the percentage of hypertension and diabetes history was significantly higher than that of the low burden group（P<0.05）.Other data:there was no significant difference in the percentage of sex,smoking,drinking,hyperlipidemia,coronary heart disease and atrial fibrillation between the two groups（P>0.05）.3.Compared with the low burden group,the levels of IL-6,ACR and BUN in the high burden group were significantly higher than those in the low burden group,suggesting that the elevated levels of IL-6,ACR and BUN were the risk factors for the increase of CSVD burden,while there was no significant difference in FIB,INR,Scr,HDL,LDL,HCY,Hb Alc and FBG between the two groups.4.Binary logistic regression analysis showed that age（OR=1.165,95%CI:1.047～1.297,P=0.005）and ACR（OR=0.28,95%CI:1.088～1.610,P=0.005）were independent risk factors for high burden of CSVD.5.ACR has the highest predictive value for CSVD high burden,with AUC value0.898,maximum yoden index 0.676,sensitivity 0.839,specificity 0.837,and the best critical value 6.295 umol/L;IL-6 takes the second place in predicting CSVD high burden,AUC value is 0.747,maximum Jordan index 0.465,sensitivity 0.710,specificity 0.735,and the best critical value 4.27pg/ml;BUN has the least predictive value for CSVD high burden,with AUC value 0.668,maximum yoden index 0.391,sensitivity 0.677,specificity 0.673,and the best critical value 5.85mmol/L.Conclusion1.Age and ACR level are independent risk factors for the increase of total burden in CSVD.2.In terms of predicting the high burden of CSVD,the efficiency of ACR is the best,followed by IL-6,both of which can be used as supplementary indicators for CSVD evaluation. |
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