Relevant Factors Analysis For Ischemic Leukoaraiosis Of Asymmetry

Objective:Research ILA and asymmetry ILA’s relevant factors,discussed it’s reasons or possible physiopathologic mechanism.Method:Choose total 182 cases patients reference (Magnetic Resonance Imaging,MRI) results divided the total patients into two groups:Group A was healthy control,total of 46 cases,19 cases of male,27 cases of female,40-75 age(mean 58.540±8.508 age).Group B were ILA patients, total of 136 cases,80 cases of male,56 cases of female,35-88 age(mean65.500±10.181 age), all groups conform to include and exclude standards. According to Fazekas rating scales’s cylindricizing(heavy side/light side grades), divided group B into asymmetry ILA group(group Bl,cylindricizing> 1.5) and symmetry ILA group (group B2,cylindricizing≤1.5).Record master samples general data:age,gender,disease diagnosis, history of high blood pressure, (Diabetes melitus, DM),(Hyperlipidaemia,HLP), (Coronary heart disease,CHD),smoking, drinking and so on, blood index and test method include:using nephelometry measure (Fasting Blood Glucose, FBG) (mmol/L), serum (Total cholesterol, TC) (mmol/L)and (Triglyceride, TG) (mmol/L) levels, surfactant direct method measure serum (High density lipoprotein-cholesterol, HDL-ch) (mmol/L) levels, endpoint method measure serum (Low density lipoprotein-cholesterol, LDL-ch) (mmol/L) levels; immunoturbidimetry measure serum (Lipoprotein(a), LP(a)) (mg/L)、serum (CystatinC, CysC)(mg/L) and (D-Dimmer, D-D) (μg/L); enzymatic cycling assay measure (Homocysteine, HCY) (umol/L); all patients tested head MRI and carotid color ultrasonognophy and record all indexs include (Intima-media thickness,IMT)、plaque numbers、size、form.and ILA’s Fazekas grades;using University of Washington carotid atherosclerostic plaque ultrasontic rating scale to grade.Analysis groups of sample datas with spss 20.0 versions of statistical software.Resultsr1.Risk factors analysis of ILAThe group B of men 80 cases,58.824%、HLP patients 69 cases,50.735%、CHD patients 34 cases,25.000%、drinker 47 cases,34.559% all significantly more than group A(19 cases,41.304%;14 cases,30.435%; 2 cases,4.348%; 8 cases,17.391%) (P<0.05, P<0.05, P<0.01, P<0.05);the group B of age (65.500±10.181)、serum TC (195.744±43.890)、TG (123.005(88.500-185.750))、HCY (18.010(14.420-21.775))、CysC (1.405(0.923～1.980)) levels、carotid atherosclerotic plaque (2 (0～ 2))and ILA’s total rating(6(4～7))all significantly more than group A(58.540±8.508); (172.787±31.727); 97.000(71.750-133.000); 13.500(10.525～16.025); 0.875(0.778-1.025); 0 (0-2); 0(0-0) (P<0.01, P<0.01, P<0.01,P<0.01, P< 0.01, P< 0.05, P< 0.01).Between groups A and B DM(P=0.219)、 hypertensive(P=0.074)、drinker of constituent ratio(P=0.070) and serum FBG(P=0.206)、HDL-ch(P=0.276)、LDL-ch(P=0.238)、LP(a) (P=0.821)、plasma D-D(P=0.482) levels were no statistically significant differences.ILA of risk factors analysis with binary logistic regression analysis:TG(OR=1.013) (P<0.01), HCY(OR=1.238) (P<0.01), age(0R=1.053) (P<0.05), Cysc(OR=2.694) (P <0.05) were all statistically significant.There was a positive correlation between age、serum HCY、CysC and order of ILA severity(around two flanks total grades), (r=0.250,P<0.01;r=0.315,P<0.01;r=0.245,P <0.01);There wasn’t statistical significance between TG and order of ILA severity.ILA risk factors’s multivariate linear regression analysis:F rating=-1.770+0.055age+0.095HCY2.Risk factors analysis of asymmetry ILAThe group Bl of DM patients 20 cases,28.986%. HLP patients 43 cases,62.319%、 hypertensive patients 45 cases,65.217%.. CHD patients 23 cases,33.333% were all significantly more than group B2(9 cases,13.433%; 26 cases,38.806%; 26 cases, 38.806%;11 cases,16.418%) (P<0.05, P<0.01, P<0.01, P<0.05); The group B1 of age (69(64-75))、serum HCY (20.130(16.170-23.925))、CysC (1.740(0.980～ 2.075))、carotid atherosclerotic plaque (2 (2～2)、cylindricizing (2 (2-2)) levels all significantly more than group B2 ((62(56-70));16.140(13.100-19.050); 1.110(0.880～1.890); 0 (0-2);1(1-1.33)(P<0.01, P<0.01, P<0.05, P<0.01, P< 0.01).The group B2’s heavy side grades 4 (4～5)、light side grades 3 (3～4) were all significantly more than group B1 (4 (2～5)、2 (1～2) levels (P<0.05,P< 0.01)Sexuality(P=0.402),drinker(P=0.257),smoker’s constituent ratio(.P=0.936),serum FBG(P=0.094),TC(P=0.552),TG(P=0.967),HDL-ch(P=0.548),LDL-ch(P=0.994),Lp(a) (P=0.858),D-D(P=0.154),left side grades(P=0.112),right side grades(P=0.328),total grades(P=0.675) levels among the groups B1 and B2 had no significantly differences.The asymmetry ILA risk factors with binary logistic regression:HCY(OR=0.918)(P <0.01),carotid atherosclerotic plaque(OR=0.324)(P<0.01),hypertension(OR=0.409) (P<0.05),age(OR=0.942)(P<0.05) were all statistically significant.There were a positive correlation between age serum HCY、carotid atherosclerotic plaque and the asymmetry ILA order of severity, (r=0.271,P<0.01; r=0.329, P<0.01; r=0.439, P<0.01);Compare with ILA’s hypertension positive history cylindricizing with group B1 and B2,high blood pressure group’s cylindricizing had statistically significant (P<0.01).Asymmetry ILA risk factors’s multivariate linear regression analysis:F cylindricizing=0.422+0.009age+0.014HCY+0.183carotid plaquesscore.Conclusion:1、ILA’s independent risk factors have age, TG, HCY, Cysc and those index levels with ILA total grades had significant positive correlation and they can reflect the severity of the ILA.2、High blood pressure、carotid atherosclerotic plaque、age、HCY were asymmetry ILA’s independent risk factors and those index levels had significant positive correlation with severity of the asymmetry ILA,between those index carotid atherosclerotic plaque and serum HCY levels were most closely with ILA asymmetry.