| Background and Aims: Stroke is one of the main causes of death in China.Domestic and foreign scholars do a lot of research on the risk factors of stroke,and they are now paying extensive attention to the relationship between smoking and ischemic stroke.Many epidemiologic evidences showed that smoking,included passive smoking,is an independent risk factor of Cerebral small vessel diseases(CSVD).At present,smoking as a risk factors of stroke,which study limited to the level of epidemiological and animal experiments,lacked solid evidence such as large clinical data to clarify it.Studies showed that nicotine,an important harmful substance in cigarette,is closely related to cardiovascular and cerebrovascular diseases such as atherosclerosis.However,nicotine is hard to detect in human body as its half-life short,but cotinine,which is the main product of nicotine metabolism,has a long half-life and is stable in human blood,so it has been a sensitive biological indicator to measure the exposure level of smokers and passive smokers.In order to accurately evaluate the level of exposure of smokers and further study the relationship between smoking and various cerebrovascular diseases,many scholars suggested that detecting the concentration of serum cotinine as the degree of smoking.Some studies on the relationship between coronary heart disease and cotinine have been reported in and abroad,but seldom see the papers on CSVD and cotinine.This study shows the interrelationships of degree of smoking,concentration of serum cotinine and the severity of CSVD patients by data statistic and analyses.Methods: A total of 538 male patients,40 and 70 years old,with high risk of ischemic stroke,were investigated in this study.Concentrations of serum cotinine were determined by enzyme-linked immunosorbent assay(ELISA).Magnetic resonance imaging(MRI)examination of patients were selected from our hospital medical record management system and judged strictly according to the diagnostic criteria of CSVD.In addition,the internationally accepted CSVD load rating scale was adopted to evaluate the load rating of CSVD.Measurement data used(?X± S),mainly related to the measurement data index K-all through single sample S testing normality analysis,for the measurement of the accord with normal distribution data set between data comparison using T test;X2 analysis was used to compare the counting data sets.Spearman correlation coefficient was adopted for single factor correlation analysis.A regression model was established for the risk factors related to the occurrence and development of the imaging load score of cerebrovascular disease,and multivariate Logistic regression analysis was conducted.The correlation between smoking,concentration of serum cotinine and cerebrovascular disease by statistical analysis.Results: In this study,we found that ageing,hypertension,diabetes and hypercholesterolemia are all risk factors of CSVD in the whole group.Furthermore,this study showed that there is a positive correlation between medium and high concentration of cotinine and smoking index,which is concentration of cotinine increased with smoking index.Therefore,we can evaluate the level of smoking exposure of high-risk population group in term of the concentration of serum cotinine changed.Meanwhile,we found that there was a significant positive correlation between concentration of serum cotinine and moderate or severe degree CSVD.Conclusions: This study shows that high concentration of serum cotinine,heavy smoking,diabetes,dyslipidemia and education level are all independent risk factor of moderate-severe CSVD.It will be increased that concentration of serum cotinine with the level of smoking in high-risk population of ischemic stroke,to increase the risk of CSVD. |
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