Risk Factors Associated With Severity Of Cerebral Small Vessel Diseases In Acute First-ever Ischemic Stroke Patients

Objective In the acute first-ever ischemic stroke,we study the relationship between the severity of cerebral small vessel diseases and the common cerebrovascular risk factors,and the subtypes of ischemic stroke.The purpose of this study is to further explore the pathophysiology mechanism of cerebral small vessel diseases and to give a proper way to prevention stroke.Methods A total of 98 first-ever ischemic stroke patients were enrolled from September2014 to September 2016 in Liyuan hospital.We collected the patient's head magnetic resonance image,the demographic data and cardiovascular risk factors.First,we classify the severity of the lacunae,perivascular space,and white matter hyperintensity.Second,we used a univariate analysis to screen out statistically significant risk factors.Multivariate logistic regression analysis was used to investigate the risk factors associated with the severity of cerebral small vessel diseases.Results The detection rate of small vessel disease was 91.9% in the 98 cases of ischemic stroke,85.7% in the deep white matter and 91.8% in the ventricle white matter.The detection rate of the perivascular space was 100%.The results of the multivariate analysis are shown below.1.The severity of white matter hyperintensity was correlated with old age(OR = 1.119,p = 0.019),increased systolic blood pressure(OR = 1.075,p =0.018),dyslipidemia(OR = 0.075,p = 0.034),and low lipoprotein a(OR = 0.992,p =0.004).2.The severity of the perivascular space in the basal ganglia was correlated with gender(OR = 27.776,p = 0.038),systolic blood pressure(OR = 1.078,p = 0.043),lipoprotein a(OR = 0.987,p = 0.016),blood sugar(OR = 0.163,p = 0.009)and glycated hemoglobin(OR = 5.67,p = 0.044).The severity of the perivascular space in the white matter area was not correlated with age(p = 0.071),gender(p = 0.998),systolic blood pressure(p=0.873),diastolic blood pressure(p= 0.207),and blood viscosity(p = 0.153).The severity of the perivascular space in the hippocampus was correlated with lacunae(OR = 3.38,p = 0.007).The severity of the perivascular space in the midbrain was correlated with diastolic blood pressure(OR = 1.089,p = 0.005).3.The severity of the lacunae was correlated with age(OR = 1.097,p = 0.038)and the white matter hyperintensity(OR = 10.9,p = 0.002).Conclusions The prevalence of cerebral small vessel diseases in the acute first-ever ischemic stroke was higher.1.Old age,increased systolic blood pressure,high blood lipids and low lipoprotein a are related to the white matter hyperintensity.2.The increase of systolic blood pressure,the decrease of lipoprotein a,the decrease of hypoglycemia and glycosylated hemoglobin are related to the perivascular space around the basal ganglia.The lacunar is related to the perivascular space in the hippocampus.The increase in diastolic blood pressure is related to the perivascular space in the midbrain area.3.Age and white matter hyperintensity are related to the lacune.