Correlation Of Plasma Fibrinogen, Homocysteine Level With Cerebral Small Vessel Disease

Objective:To investigate the relationship between plasma fibrinogen(FIB)and homocysteine(Hcy)and cerebral small vessel disease(CSVD).To explore the pathogenesis that FIB and Hcy lead to CSVD,so that theoretical basis for early diagnosis and early intervention of CSVD could be provided.Methods:Continuously selected 210 patients with CSVD from January 2016 to March 2017 in Department of Neurology,Affiliated Hospital of Chengde Medical College,including 79 cases of LI and 131 cases of WML.In the control group,there were 75 subjects who had no neurological diseases,and no abnormalities were found in the cranial imaging.Each patient underwent craniocerebral MRI examination and was independently diagnosed by two neurologists trained in neuroimaging.According to lesions number,LI patients were divided into single group(one lesion)and multiple group(two or more lesions).According to Age-Related White Matter Changes(ARWMC)scale,WML patients were divided into mild,moderate and severe.Gather the information about all people's gender,age,history of smoking and drinking,history of hypertension and diabetes,plasma FIB,Hcy,imaging and other clinical data.All the datas were analyzed by SPSS 19.0.The measurement data was demonstrated by mean and standard deviation(x±s),the two groups were compared using independent sample t test,multiple groups were compared using one-way analysis of variance.Count data was demonstrated by the number of case and rate,the two groups were compared by the?~2 test.The multi-factor sequential Logistic regression analysis the risk factors of LI and WML severity.When P<0.05,the difference was statistically significant.Results:1 The age,hypertension ratio,plasma FIB and Hcy levels in the LI group were higher than the control group(P<0.05).In the LI subgroup,the proportion of hypertension and plasma Hcy levels in multiple group were significantly higher than single group(P<0.05).Multivariate logistic regression analysis showed that for age,hypertension,high levels of FIB and Hcy were independent risk factors for LI.Hypertension and high levels of Hcy were independent risk factors for increased LI severity(P<0.05).2 The age,proportion of hypertension and diabetes,plasma FIB and Hcy levels in the WML group were higher than the control group(P<0.05).Compared with the WML mild group,the age,hypertension,and FIB in the moderate group were all significantly increased.The age,hypertension,FIB and Hcy in the severe group were all significantly increased(P<0.05).Compared with the moderate group,the Hcy level in the severe group was significantly higher(P<0.05).One-way ANOVA analysis of WML severity showed that age,hypertension,diabetes,high levels of FIB and Hcy were all risk factors for the increased severity of WML(P<0.05).Multi-factorial and orderly multi-category logistic regression analysis showed that age,hypertension,diabetes,high levels of FIB and Hcy were risk factors for the increased WML severity(P<0.05).Conclusion:Plasma FIB and Hcy were independent risk factors of LI and WML respectively,it is suggested that the levels of FIB and Hcy are closely related to the occurrence and development of CSVD.The level of Hcy was positively correlated with the severity of WML and LI,which suggests Hcy is the risk factor of increasing the severity of WML and LI.FIB is the risk factor of increasing the severity of WML.There are differences in risk factors for the severity of LI and WML.