Analysis Of Risk Factors For The Severity And Location Of Cerebral Hemorrhage In Patients With Acute Cerebral Infarction

ObjectiveThe purpose of this study was to investigate the risk factors for affecting the severity and location of cerebral microbleeds in acute cerebral infraction patients. We used the magnetic resonance imaging(MRI) in T1 WI, T2 WI,DWI, T2- FLAIR and SWI sequence to diagnosis the CMBs in patients with acute cerebral infarction.Materials and Methods Methods:General information Collected the Clinical and iconography information of334 acute cerebral infraction patients with CMBs diagnosis by SWI. All the patients were treated in the First Affiliated Hospital of Nanchang University from October2013 to October 2015.Imaging equipment and grouping Using 3.0T superconducting magnetic resonance scanner produced by German SIEMENS,T1 WI,T2WI, DWI, T2-FLAIR and SWI sequences are examined. Record the CMBs number and distribution of all patients. According to the number of CMBs in patients with acute cerebral infarction divide into groups mild(1 ~ 2), moderate(3 ~ 9), severe(≥10). And then Combine the moderate and severe. Divide the brain into cortex-subcortex,deep(basal ganglia, thalamus, internal capsule, capsule and corpus callosum) and Subtentorial(brain stem and cerebellum) group with the microbleed anatomical rating scale made by Gregoire. So all the patents were divided into cortex-subcortex and non-cortex-subcortex or deep and non-deep groups.Statistical method SPSS.17.0 software was used to analyze the risk factors of age, sex, hypertension, diabetes mellitus, blood biochemistry, carotid atherosclerosis,thyroid function, and stroke in each group. Logistic regression analysis was carried out with a single factor analysis of the factors(P < 0.05) as the independent variables.Results1 In 334 cases of acute cerebral infarction complicated with CMBs, the totalamount of cerebral micro hemorrhage was 2108.In which cortex-subcortex 875(41.51%),basal ganglia 683(32.40%),brain stem 221(10.48%)number,thalamus, 192(9.11%) and cerebellum, 137(6.50%).With deep CMBs875(41.51%),cortex-subcortex 875(41.51%),and Subtentorial 358(16.98%).2 The mild group 168 cases(48.84%), moderate group 120 cases(34.88%),severe group 56 cases(16.28%).Univariate analysis showed that among three groups the hypertension(P = 0.020), high homocysteine levels(P=0.021) has the significant differences with statistical significance. There were no significant differences in age,sex, LDL, HDL, TG, GFR, thyroid function, diabetes, stroke history and carotid atherosclerosis and has no statistical significance(P > 0.05).3. Combining the moderate group and severe groups and then Compared with the mid group. Univariate analysis showed that among two groups the hypertension(P = 0.011), age(P = 0.029) has the statistical significance. There were no significant differences in HHcy, sex, LDL, HDL, TG, GFR, thyroid function, diabetes, stroke history and carotid atherosclerosis and has no statistical significance(P > 0.05). In multivariate logistic analysis, age(OR=0.575,95%CI:0.363~0.910,P=0.018)and hypertension( OR=1.687, 95%CI : 1.085 ~ 2.623, P=0.020) were two independent risk factors of moderately severe group.4 Statistical analysis the Clinical data of cortex-subcortex and non-cortexsubcortex. There were no significant differences in age, hypertension,HHcy, sex,LDL, HDL, GFR, thyroid function, diabetes, stroke history and carotid atherosc-lerosis and has no statistical significance(P > 0.05). Univariate analysis showed that among two groups the TG(P = 0.019) has the statistical significance. In multivariate logistic analysis TG(OR=0.641,95%CI:0.389~1.056,P=0.081)was not the independent risk factors of cortex-subcortex group.5 Statistical analysis the Clinical data of deep and non-deep groups. There were no significant differences in age, TG,HHcy, sex, LDL, HDL, GFR, thyroid function,diabetes, stroke history and carotid atherosclerosis(P > 0.05). Univariate analysis showed that among two groups the hypertension(P = 0.001) has the statistical significance. In multivariate logistic analysis TG( OR= 2.199,95%CI : 1.347 ~3.591,P=0.002)was not the independent risk factors of deep group.Conclusion1 Hypertension and age are the independent risk factors of CMBs in the moderate and severe group, Hypertension is the risk factor and age is the protective factor.2 Hypertension is an independent risk factors for deep CMBs in acute cerebral infarction patients.