| Background and objective: White matter hyperintensity(WMH)affects the occurrence,development and prognosis of ischemic stroke.As we all know,hemodynamic compromise is an important factor in the pathogenesis of WMH.The pathogenesis of cerebral watershed infarction(WSI)is closely related to embolism and hemodynamic compromise.Based on this,WMH and WSI may be related.In this study,patients with cortical watershed infarcts(CWSI)and deep watershed infarcts(DWSI)were included.The purpose was to explore:1.Influencing factors of CWSI and DWSI;2.Correlation between CWSI,DWSI and WMH load;3.Correlation between WMH load and functional prognosis in patients with WSI;4.Influencing factors of WMH in different parts of WSI patients.Methods: In strict accordance with the inclusion and exclusion criteria,34 patients with CWSI and 46 patients with DWSI were included in this study.All participants were informed of the purpose and precautions of this study and signed informed consent.The data of imaging,common vascular risk factors and NIHSS score were collected.The patients were divided into CWSI group and DWSI group according to bogousslavsky classification method.The total WMH volume,periventricular white matter hyperintensity(PVWMH)volume and deep white matter hyperintensity(DWMH)volume of the subjects were measured by white matter hyperintensities analysis tools(WHAT).The patients with WSI were followed up by telephone at 1month,3 months and 6 months after the disease,and were divided into good prognosis and poor prognosis groups according to the modified Rankin score(m RS).Finally,the data are counted,sorted and analyzed.Results: 1.Comparing the risk factors between CWSI and DWSI patient groups,there were significant differences in atrial fibrillation,abnormal ventricular wall structure and admission NIHSS score between the two groups(P < 0.05).The incidence of atrial fibrillation and abnormal ventricular wall structure in CWSI group was higher than that in DWSI group,while the NIHSS score in admission in CWSI group was lower than that in DWSI group;2.There was significant difference in PVWMH volume distribution between CWSI and DWSI patients(Z= 4.381,P < 0.001),and the median PVWMH volume in CWSI group(3.800 vs 5.900)was lower than that in DWSI group;3.After controlling for confounding factors,the PVWMH volume in CWSI patients increased the risk of poor prognosis in 6 months(OR =0.369,95% CI = 0.146-0.933,P = 0.035),and the PVWMH volume in DWSI patients increased the risk of poor prognosis in 3 months(OR =2.338,95% CI = 1.080-5.063,P = 0.031)and 6 months(OR = 1.595,95% CI= 1.046-2.432,P = 0.030);4.After controlling for confounding factors,age had a significant effect on the total WMH volume(b =0.012,95% CI = 0.000-0.024,P = 0.046)and the PVWMH volume(b =0.042,95%CI= 0.024-0.060,P< 0.001);Hypertension had a significant effect on the total WMH volume(b = 0.262,95% CI = 0.066-0.459,P= 0.010)and the PVWMH volume(b = 0.388,95% CI = 0.096-0.679,P= 0.010);HHcy had a significant effect on the total WMH volume in patients with WSI(b value = 0.267,95% CI = 0.051-0.483,P = 0.016).Conclusions: 1.CWSI group was more often associated with atrial fibrillation and abnormal cardiac wall structure,and the clinical symptoms were relatively mild;2.There are differences in the distribution of PVWMH volume between CWSI group and DWSI group;3.PVWMH volume but not DWMH volume increased the risk of poor functional prognosis in 6 months after CWSI disease,and PVWMH volume but not DWMH volume increased the risk of poor functional prognosis in 3 months and 6 months after DWSI disease;4.Age,hypertension and HHcy affect the total volume of WMH in patients with WSI,and age and hypertension affect the PVWMH volume in patients with WSI. |
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