Correlation Study Between Cerebral Microbleeds And Serum Uric Acid Level In Patients With Acute Ischemic Stroke

Purpose:Acute ischemic stroke is a common disease of Nerve physician in clinic, Features of acute onset, high recurrence rate and mortality rate, especially in the elderly population,pose a severe threat to the health and safety of human. With the constant perfection of clinical medicine technologies and the deepening of clinical researches, microvascular diseases such as cerebral microbleeds (CMBs) are increasingly valued. Agreat number of clinical researches show that CMBs is closely related to the cerebral hemorrhage tendency of ischemic cerebrovascular disease.CMBs is one of the small vessel diseases,a low-signal round or similar round coloboma on MR susceptibility weighted imaging (SWI),other common diseases including lacunar infarction and leukodystrophy. Histopathologic examination shows hemosiderosis. According to current studies, the number of CMBs and the incidence of cerebral hemorrhage are in positive correlation. Therefore, the studies on CMBs, especially the analysis of risk factors of acute cerebral infarction, can provide meaningful guidance for the treatment and prevention after ischemic stroke.Clinical researches suggest a correlation between the increasing level of serum uric acid and ischemic stroke. However, The correlation between uric acid and cerebral microbleeds are less reported in the domestic and foreign literatures. This thesis aims to illustrate the relationship between uric acid and CMBs as well as cerebral small vessel disease.Method:236 patients diagnosed with ACI in the MRI GE-T2WI+SWI test of our hospital between March 2010 and March 2014 are selected, laboratory data on population, clinic and uric acid level are collected, CMB group related risk factors and biochemical index are compared to see if there is any difference. Meanwhile, the method of MRI GE-T2WI+SWI is adopted to test CMBs and find if there is difference between the occurrence of CMBs and serum uric acid. The analytical method of logic reverse deduction is adopted to test the relationship between uric acid and CMBs.Results:80 are CMBs patients among 236 patients. Age, gender, history of stroke, and diabetes were statistically significant(P<0.05).Patients with hypertension, hyperuricemia, and high level of white matter lesions are more likely to appear in CMBs (P<0.01).After controlling the possible confounding factors, the rise of uric acid level correlates with the occurrence of CMBs (the control odds ratio of the highest and lowest level of quartile [OR],1.96; 95% confidence interval [CI], 1.17-3.52). Such correlation exists in the deep brain or subtentorial brain of the CMBs patients (including or excluding lobe CMBs) instead of lobe CMBs patients in the strict sense. In addition, such correlation is more obvious for patients with hypertension (control odds ratio of the highest and lowest level of quartile OR is 2.89; CI is 95%,1.58-5.77). However, no such correlation has been found in patients without hypertension.Conclusion:Uric acid correlates with the occurrence of CMBs. But it is not an independent risk factor.The correlation between uric acid and CMBs is particularly obvious in hypertension patients,and it is mainly associated with the deep brain or under the condition of the cerebellum CMBs.