Influence Of Smoking Degree On Cognitive Function Of Cerebral Small Vessel Disease

ObjectiveTo investigate and analyze the influence of smoking degree and other factors on cognitive dysfunction in patients with cerebral small vessel disease(CSVD),and to provide a theoretical basis for preventing and treatment the occurrence and development of cognitive dysfunction in CSVD patients.Method123 patients with CSVD who were admitted in the department of Neurology in the Zhong Shan Hospital Affiliated with Dalian University from October 2016 to December2017 were enrolled.All testees underwent MRI scan and head and neck vascular examination,and were strictly diagnosed in accordance with the consensus of "Chinese Consensus on Diagnosis and Treatment of Cerebrovascular Disease" in 2015.All testees performed cognitive function assessment through the Montreal Cognitive Assessment(Mo CA)scale,sixty-two patients with Mo CA scale score were less than 26 points who were defined as cognitive impairment and used as experimental group,and sixty-one patients with Mo CA scale score were more than or equal to 26 points who were defined as nor-mal cognitive function and used as control group.Multivariate analysis was performed on risk factors in both groups,which inclued the history of smoking,degree of smoking,age,education level,history of hypertension,history of diabetes mellitus,history of drinking,body mass index(BMI),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol (HDL-C),and serum uric acid(UA).To determine the CSVD patients with cognitive impairment the independent risk factors of occurrence and development.Further analysis the correlation between the smoking severity and cognitive level in CSVD patients.ResultsThere were 40 cases(64.52%)with smoking history,21 cases(33.87%)with severe smoking,age(68.24 ± 8.64)years,education level(9 ± 2.1)years,47 cases(75.81%)with history of hypertension in the experimental group.There were 23 cases(37.7%)with smoking history,6 cases(9.83%)with severe smoking,age(58.84 ± 7.37)years,educa-tion level(10.95 ± 1.98)years,34 cases(55.7%)with hypertension of history in the control group.There was significant difference in the history of smoking,heavy smoking,age,education level and history of hypertension in two groups of patients with CSVD(P <0.05);There was no significant difference in the history of mild smoking,moderate smoking,stopping smoking,history of diabetes mellitus,history of drinking,BMI,TG,TC,LDL-C,HDL-C,and UA(P> 0.05).According to the results of univariate analysis,the severe smoking,age,education were regarded as independent variables,cognitive i-mpairment were regarded as a dependent variable,and multivariate Logistic regression analysis showed that severe smoking(OR=4.667,95%CI 1.196-15.123,P=0.025),age(OR=1.155,95%CI 1.081-1.234,P=0.000),and education level(OR=0.685,95%CI 0.54 6-0.861,P=0.001)were independent risk factors of cognitive impairment in CSVD patients(P <0.05).There was a negative correlation between the degree of smoking and the level of cognitive function in CSVD patients(P <0.05).Conclusions1.Severe smoking,old age,low level of education are independent risk factors for cognitive dysfunction in CSVD;2.There is no significant correlation between mild smoki-ng,moderate smoking,stopping smoking and cognitive decline in patients with CSVD;3.With the increase of smoking,the more obvious impairment of cognitive function in CSVD patients.