| With the nuclear magnetic resonance(NMR) and GRE sequence SWI sequence technology is widely used in clinical, brain capillary hemorrhage was much higher, with the 1994 Schaxf etc, puts forward the concept of hemorrhage lacunar Fazekas by 1999 through pathology confirmed the existence of micro cerebral hemorrhage, cerebral micro hemorrhage(cerebralmierobleed, CMBs) gradually be neurologist scholars have extensive and in-depth research. Micro brain hemorrhage(cerebralmierobleed, CMBs) are small vascular lesions, tiny blood vessels in the brain burst bleeds, cause of hemosiderin, hemosiderin deposition of a subclinical lesions [1] the end-stage of tiny blood vessels. In 2010 in the new cerebrovascular disease classification was officially classified as a subtype of small vascular disease of the brain. Offenbacher [2] for the first time such as described in the GRE sequence 2-- 5 mm in diameter ovoid signal to reduce area, the surrounding edema. In addition also need to rule out small intracranial vascular clearance, hemosiderin deposition between the pia mater and subcortical calcifications. Several studies show that CMBs tiny blood vessels is not only one of the symbols of damage and clinical. PartⅠ Different cerebrovascular disease cerebral hemorrhagerisk factor a analysisObjective: Different cerebrovascular disease cerebral hemorrhage risk factor analysis.Method: Choose collected in January 2012- December 2014 in hebei province people’s hospital neurology hospital information complete, 160 cases of cerebrovascular disease(acute cerebral infarction 91 cerebral hemorrhage 38 transient ischemic attack31), according to the micro with cerebral hemorrhage(CMBs) is divided into two groups. CMBs of test group(+) 89 cases and control group in CMBs(-) in 71 cases; Registration respectively in patients with general clinical data including: age, gender, smoking, drinking; Presence of merge hypertension, coronary heart disease, diabetes, Lacunar cerebral infarction. Records of laboratory biochemical indexes, total cholesterol(TC), low density lipoprotein(LDL)-c), uric acid, fibrinogen and homocysteine levels numerical; Position and number of degree of micro and cerebral hemorrhagecerebral microbleeds CMBs. Use of statistical software SPSS16.0, cerebrovascular disease CMBs further regression analysis(+) and TC, LDL- C, uric acid, fibrinogen and homocysteine between dangerous relationship.Results:1 The general clinical case analysis:Into the group of patients 160 cases, CMBs(+), 89 cases of detection rate of 55.6%. First diagnosis includes(transient ischemic attack 31 cases, 91 cases of acute cerebral infarction, cerebral hemorrhage, 38 cases, 91 cases(56.8%) of men, women, 69 cases(43.2%), there are 88 cases(55.0%), smoking history, has a history of drinking, 70 cases(43.7%), 138 patients with hypertension(+ 78-59. 56.5%), 83 patients with diabetes(65.1% + 54 cases- 29 cases), 74 patients with coronary heart disease(41 cases, 33 cases 55.4%), the combination of high total cholesterol lipidemia in 77 cases(74.1% + 57 cases, 20 cases), 69 patients with high and low density lipoprotein + 48 cases, 21 cases(69.5%), 38 patients with high uric acid blood lipids(+ 14 cases- 24 cases 36.8%), 29 patients with high plasma fibrinogen(+ 10 cases- 23 cases(34.4%), the high homocysteine levels, 29 cases + 18 cases, 11 cases(62.1%).2 Different types of diseases combined rate CMBs:In CMBs(+) groups of detection: cerebral hemorrhage highest 71.1%; Second acute cerebral infarction detection rate 51.6%; Finally, transient ischemic attack detection rate 48.3%; 2. Always different diseases combined CMBs(+) groups: diabetes, hypertension, coronary heart disease, 56.5% and 55.4%, 65.1%(3) biochemical indicator detection group CMBs(+) detection rate, high total cholesterol70.1%, blood fat, high69.5% and low density lipoprotein cholesterol,62.1%, high homocysteine blood fat, high fibrinogen blood fat34.4%, high uric acid blood fat 6.8%.3 Inspection area, number of micro brain bleedingIn CMBs(+) in the group: cortex- the highest percentage of subcortical 79.7%, then 68.5% proportion of the basal ganglia, thalamus, Second 41.5% proportion of the cerebellum, The final 26% proportion of the brain stem,Quantity degree classification: mild(1-2), the highest proportion of 76.4%, moderate(3-10) 21.3%;(> 10) 0.02%;4 Brain micro bleeding risk factor analysis:With CMBs(+)of CMBs(-):age, merging, cerebral infarction, cerebral hemorrhage and hypertension ratio difference was statistically significant(P < 0.05); Comparing the two groups after total cholesterol, high and low density lipoprotein hematic disease, high blood homocysteine was statistically significant(P < 0.05); And high urea, high fibrinogen levels, no statistically significant difference(P > 0.05). PartⅡ Atorvastatin influence on micro brain hemorrhageObjective: Research the micro cerebrovascular disease with cerebral hemorrhage treated with atorvastatin cholesterol-lowering effect for the treatment of many micro brain hemorrhage.Methods: the first part of the group of micro bleeding in patients with cerebrovascular disease with cerebral extraction of 30 cases of patients treated with atorvastatin, according to the blood fat cholesterol level is divided into three groups, each group to different dose of statins; Intensive lipid-lowering group 40 mg/d, the standard lipid group 20 m/dg and non lipid-lowering 0 mg/d. Three months after the SWI review record brain bleeding, quantity, check blood total cholesterol, low density lipoprotein cholesterol(hdl-c) level. Micro comparison before and after medication brain hemorrhage changes with or without statistical significance.Results:1 Strengthen the group or standard lipid-lowering treatment after 3 months, there is a decrease in the level of total cholesterol, low density lipoprotein(P < 0.05); Rather than lipid-lowering treatment group total cholesterol, low density lipoprotein cholesterol(ldl-c) levels in no significant change(P > 0.05).2 Into the group of 30 cases, only change the micro bleeding occurred in 5 cases, 3 cases of patients with lesions increase 1 40 magnesium 2 20 mg group(1), 1 case of increased 2(20 mg group), and 1 case of adding four group(0 mg); Micro brain hemorrhage stove quantity change there was no significant difference.Conclusions:1 Different cerebrovascular disease rate CMBs: merge cerebral hemorrhage, highest again lacunar cerebral infarction, and acute cerebral infarction again, TIA minimum; Micro hemorrhage, good location, quantity.2 Brain cortex, subcortical proportion, basal ganglia, thalamus, once again, the cerebellum, brainstem minimum; Patients with mild degree of number(1-2) has the highest proportion.3 Cerebral infarction, lacunar cerebral infarction, cerebral hemorrhage, positively correlated with CMBs, for its high risk factors.4 Total cholesterol, high density lipoprotein hematic disease, high homocysteine levels, and for the CMBs were positively correlated, its risk factors.5 Uric acid, fibrinogen, and no obvious correlation CMBs.6 Atorvastatin therapy can reduce cholesterol, low density lipoprotein to normal levels.7 The short-term atorvastatin lipid-lowering treatment will not increase the risk of micro brain hemorrhage. |
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