Correlation Analysis Of Cerebral Microbleeds Risk Factors In Patients With Ischemic Stroke

Background and Purpose:Cerebral micro-hemorrhage(Cerebral Microbleeds,CMBs)is one of the important manifestations of small cerebral vascular disease.At present,it is believed that multiple CMBS suggest a higher risk of bleeding,and the CMBS site is likely to be the site of future intracerebral hemorrhage.The study found that CMBS was closely related to many clinical diseases,and literature reported that the incidence of CMBS in stroke patients was significantly higher than that of normal people.However,the correlation between the pathogenesis and prognosis of CMBS is still rare,it is worth exploring further.At present,the possible risk factors of CMBS are: sex,age,smoking,drinking,dyslipidemia,inflammatory factors,hypertension,coronary heart disease,diabetes mellitus,atherosclerosis and so on.As an early indicator of systemic atherosclerosis,carotid intima-media thickness(Carotid Intima-Media Thicken,CIMT)is an independent predictor of cerebrovascular disease in stroke patients.However,it is still unknown whether it is possible to predict the occurrence of CMBS by detecting CIMT.Inflammatory reaction plays an important role in the pathogenesis of atherosclerosis.As a newly discovered inflammatory response marker,the neutrophil/lymphocyte ratio(Neutronphil To Lymphocyte Ratio,NLR)can fully represent the degree of inflammation occurring.Therefore,it is speculated that neutrophil/lymphocyte ratio(NLR)may also have a certain predictive value for the occurrence of CMBS in patients with ischemic stroke.By detecting the CIMT and NLR of CMBS patients and the normal population,and by further analyzing the correlation between CIMT,NLR and CMBS,the study aims to provide more theoretical basis for predicting the occurrence,development and prognosis of CMBS.Methods:1.In our hospital from January 2017 to January 2018 admitted 121 cases of acute non-cardiac ischemic patients,according to the cranial MRI SWI sequence on the CMBS group,non-CMBS group.2.All patients were drained on an empty stomach after admission,while in hospital the head magnetic resonance(MRI)and the cervical vascular color Doppler ultrasonography were examined.On the basis of MRI magnetic sensitive weighted imaging(SWI)There were no CMBS divided into CMBS and non-CMBS groups.3.Detection of clinical baseline data of two groups of patients,biochemical indicators(including neutrophils,lymphocytes,NLR,fasting blood glucose,fibrinogen,cholesterol,triglycerides,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,etc.),neutrophil/lymphocyte ratio,The number and distribution of cerebral micro-hemorrhage revealed by carotid intima-media thickness and SWI sequence.4.Logistic regression analysis was used to study the correlation between the occurrence of cerebral micro-hemorrhage and the above factors,as well as the relationship between the number and distribution of cerebral micro-hemorrhage and the ratio of neutrophils/lymphocytes and carotid intima-media thickness.5.Image evaluation: According to the latest diagnostic criteria of CMBS,all MRI images are reviewed by the imaging and neuro-experienced physicians,respectively,to record the number and distribution of CMBS.According to the number of CMBS,divided into mild(1-4),moderate(5-9),severe(?10),according to the dispersion-weighted imaging results will be CMBS distribution,divided into cortical-cortical group,basal ganglia/thalamus Group,screen group and mixed group.The observer scale of intracerebral hemorrhage was also consulted to improve the consistency among different researchers.Results:1.The average age of CMBS group was higher than that of non-CMBS Group(p<0.001),and the proportion of hypertension was also significantly higher than that in non-CMBS group(p=0.002).However,the proportion of smoking(p=0.001)and alcohol consumption(p=0.019)in CMBS group was significantly lower than that in non-CMBS group.There was no significant difference in sex composition,diabetes mellitus and coronary heart disease between the two groups(p>0.05).2.Compared with the non-CMBS group,the CMBS group CIMT(p=0.009),NLR(p=0.038)significantly increased,the difference was statistically significant(p<0.05),two groups of neutrophils count,lymphocyte count,fasting blood glucose(FBG),Fibrinogen(FIB),There was no statistically significant difference in triglyceride(TG),total cholesterol(CHOL),high-density lipoprotein cholesterol(HDL-C)and Low-density lipoprotein cholesterol(LDL-C)(p>0.05).3.Multivariate logistic regression analysis suggested that the higher age(OR=1.097,95%CI:1.043-1.153),hypertension status(OR=2.945,95%CI:1.120-7.740),CIMT greater than 1mm(OR=2.471,95% CI:1.044-5.847)are the risk factors of CMBS occurrence.High triglyceride(p=0.050)may be associated with the occurrence of CMBS.Binary logistic regression analysis showed NLR(OR=1.036,95%CI:0.962-1.116)as CMBS the risk factors that occur.4.CIMT=(p=0.032),NLR=(p=0.048)were found to differ in CMBS patients of varying degrees(light,moderate,and severe)in CMBS group.The CIMT of severe group CMBS and light and moderate CMBS was statistically significant(p<0.05).5.According to the location of CMBS,there was no statistically significant difference between NLR and CIMT(p>0.05).6.Through the Spearman rank correlation statistic analysis,There was a positive correlation between the CIMT level and the occurrence of CMBS(rs=0.203,p=0.011).The NLR level and CMBS's occurrence exists the positive correlation(rs=0.203,p=0.026).There was no correlation between CIMT and NLR level(Rs =-0.111,p=0.4),no statistically significant differences were found.Conclusion:1.A higher age(> 70 years),Hypertension,CIMT>1mm,NLR are all risk factors for the occurrence of CMBS.2.High triglyceride may be associated with the occurrence of CMBS.3.Neutrophil counts,lymphocyte counts,fasting blood glucose,fibrinogen,total cholesterol,low-density lipoprotein cholesterol,and high-density lipoprotein cholesterol are may not risk factors for CMBs.4.The severity of three grades CMBs lesions was related to CIMT and NLR,but not to the location of CMBS.And with the CIMT thickening will affect the severity of CMBs.