The Incidence And Risk Factors Of Cerebral Microbleeds In Patients With Large Artery Atherosclerosis In Acute Stage

Objective: To investigate the incidence of cerebral microbleeds(CMBs)in large artery atherosclerosis(LAA)acute phase,and to discuss the relevant risk factors in CMBs development in LAA acute phase.Method:According to TOAST classification diagnosis(2007,revised edition),a total of 78 LAA acute phase patients hospitalized at neurology department at people’s hospital of Liaoning province(2016.04-2017.02)were recruited in this study.All cases received MRI plain scanning by US GEDiscovery MR3.0T magnetic resonance imaging system,diffusion weighted imaging(DWI),magnetic resonance angiography(MRA)and susceptibility-weighted imaging(SWI)in emergency department after excluding 6 cases of already occurred CMBs and 7 cases of thrombolytic therapy,65 cases were selected as research objective.Neurologic impairment degree was evaluated via National Institutes of Health Stroke Scale(NIHSS)in all included patients within 24 h after admission.After 12 h fasting,biochemical examination was conducted by drawing median cubital venous blood at 7 o’clock in the next morning,including triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),homocysteine(HCY),uric acid(UA)and fibrinogen(FBI).From 24 h to 1 week after admission,re-examination ofhead SWI scanning was implemented.Radiographic images were read by experienced associate chief physicians from MRI division and neurology department.If there was any difference in conclusion,the agreement was reached by referring to Brain Observer Microbleed Scale(BOMBS),and then the sites and numbers of CMBs were recorded.To investigate the CMBs positive rate in LAA acute phase patients;All patients were divided into two groups according to the occurrence of CMBs,namely CMBs group and non-CMBs group.Gender,age,weight,smoking,drinking,hypertension,type 2 diabetes,blood lipids(TC、TG、HDL-C、LDL-C),HCY,UA and FBI were included in the single factor analysis between these two groups,in order to find the possible statistical significance.By setting the statistically significant factor as independent variable and CMBs as dependent variable,multiple logistic regression analysis was conducted to understand the relevant independent risk factors in CMBs development.Result:1.CMBs incidence indicated:The CMBs incidence in LAA acute phase patients was 60%;2.Single factor analysis indicated:Gender(male),hypertension,HDL-C and UA showed statistical significances between with CMBs cases and without CMBs cases;3.Multiple factor analysis indicated:Gender(male;OR=3.844,95 % CI 1.277-11.57,P=0.017)and hypertension(OR=3.204,95%CI 1.072-9.575,P=0.037)had statistical significance.Conclusion:1.The incidence of CMBs in LAA acute phase patients was 60%;2.The relevant risk factors of CMBs in LAA acute phase patients were gender(male),hypertension,HDL-C and UA;3.The independent risk factors of CMBs in LAA acute phase patients were gender(male)and hypertension.