| Part one Risk factors of cerebral microbleeds in patients with acute ischemic strokeObjective:To investigate the incidence,distribution and risk factors of cerebral microbleeds in patients with acute ischemic stroke.Methods:153 patients with acute ischemic stroke(AIS)admitted to Hebei People’s Hospital from September 2017 to December 2018 were divided into CMBs group and no-CMBs group according to the results of susceptibility-weighted imaging(SWI)examination.The number and distribution of CMBs in all patients were evaluated and graded,and clinical data including biochemical test results were collected.Correct statistical methods were used to analyze the risk factors of CMBs.Results:Among 153 patients,71 were in CMBs group and 82 in no-CMBs group.The incidence of CMBs was 46.4%.According to the number of CMBs,all patients were divided into mild,moderate and severe,and according to the location,they were divided into three areas:subtentorial,deep and lobe.Comparing the demographic and clinical data of the two groups,it was found that the two groups had statistical differences in hypertension,cerebral hemorrhage and cerebral infarction.Further binary logistic regression analysis showed that hypertension and cerebral hemorrhage were risk factors for CMBs(P<0.05).There were no significant differences in gender,age,BMI,diabetes,coronary heart disease,fasting blood glucose,lipid level,homocysteine level and serum uric acid between the two groups(P>0.05).Conclusion:There are statistical differences in hypertension,cerebral hemorrhage and cerebral infarction between CMBs group and no-CMBs group.Hypertension and cerebral hemorrhage are independent risk factors for CMBs.Part two The correlation between cerebral microhemorrhage and cogni-tive function after stroke.Objective:To investigate the cognitive function of AIS patients one month after stroke,and to analyze the correlation between CMBs and cognitive function.Methods:81 patients were selected from the first part of the study for neuropsychological assessment.The scores of MoCA,MMSE,HAMD and HAMA were recorded.All patients were divided into CMBs group(30 cases)and CMBs group(51 cases)according to whether CMBs existed on SWI.The correlation between CMBs and cognitive function was analyzed by X~2 test,independent sample t test,Kruskal-Wallis H test and Spearman correlation test.Results:1.Among 81 patients,54 had cognitive impairment(66.67%),18 had anxiety(22.22%)and 12 had depression(14.81%).The incidence of cognitive impairment was different between CMBs group and no-CMB group(X~2=5.718,P<0.05).There was no significant difference in the incidence of anxiety and depression(P>0.05).2.Comparing the scores of neuropsychological scale between CMBs group and no-CMBs group,it was found that there were significant differences in the overall cognitive function,executive function,naming,attention,language function and orientation between the two groups(P<0.05).The score of CMBs group was lower than that of no-CMBs group.3.Comparisons among the groups after CMBs quantitative grading showed that there were differences in overall cognitive function,executive function,naming and attention between the four groups.No statistical differences were found between the two groups after further comparisons(P>0.05).4.Overall cognitive function,naming,attention and executive function were negatively correlated with CMBs in all parts of the brain(P<0.05);Executive function was negatively correlated with white matter lesions(P<0.05);Language function was negatively correlated with WMC,subtentorial and deep CMBs(P<0.05);Delayed recall was negatively correlated with WMC and subtentorial CMBs(P<0.05),but not with deep and lobe CMBs.Conclusion:1.The incidence of PSCI is high and involves multiple cognitive domains.Depression and anxiety are common in patients with acute stroke.2.CMBs is related to cognitive impairment after stroke.There are statistical differences in overall cognitive function,executive function,naming,attention,language function and orientation between CMBs group and no-CMBs group.3.There were differences in overall cognitive function,executive function,naming and attention among the groups after CMBs quantitative classification.4.Overall cognitive function,naming,attention and executive function were negatively correlated with CMBs in all parts,executive function was negatively correlated with WMC,language function was negatively correlated with WMC,subtentorial and deep CMBs,and delayed recall was negatively correlated with WMC and subtentorial CMBs. |
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