Correlation Between Early Renal Function Index And Cerebral Microhemorrhage In Patients With Acute Cerebral Infarction

Objective:The purpose of this study was to investigate the correlation between early renal function indicators,especially serum cystatin C level,and cerebral microhemorrhage.Methods:1.Patients with acute cerebral infarction who were admitted to the neurology department of the affiliated hospital of hebei university from July 2017 to June 2018 and met the inclusion criteria of this study were selected consecutively.2.?1?general information of the patients:age,gender,smoking history;Basic diseases and laboratory data:hypertension,diabetes,hyperlipidemia,hemoglobin,hypersensitive c-reactive protein,lacunar infarction,white matter thinning,estimated glomerular filtration rate,cystatin C.?2?all cases met the diagnostic criteria proposed in the 2014 guidelines for the diagnosis of acute ischemic stroke published in the Chinese journal of neurology in 2015.According to the presence or absence of CMBs lesions on the susceptibility weighted imaging?susceptibility weighted imaging?,the patients were divided into the CMBs group and the non-cmbs group.?3?CMBs were recorded in accordance with the standard map of microbleed anatomical rating scale?MARS?^[1].According to the parts of CMBs,they were divided into the CMBs group in the cerebral lobe,the CMBs group in the deep part or the subtensive part,and the CMBs group in both parts^[2].?4?the grading standard for the quantity of microhemorrhage was grade 0,none;Level 1,1-5;Level 2,6¹5;Level 3,more than 15"^[3].The patients were divided into 4groups according to the number of microhemorrhages.3.SPSS 22.0 statistical software was applied to select appropriate statistical methods for statistical analysis of the obtained data.Results:1.A total of 106 hospitalized patients with acute cerebral infarction during the study met the inclusion criteria.The mean age was 62.41 9.87 years.Age,hypertension,lacunar infarction,white matter osteoporosis,CRP,estimated glomerular filtration rate,cystatin C and CMBs were significantly correlated?P<0.05?.There was no significant difference in CMBs among diabetes mellitus,smoking,dyslipidemia and hemoglobin?P>0.05?.In the group of cerebral microhemorrhage,the combination of deep white matter was the main cause.The number of patients with lacunar infarction was 85.5%?table 2-1?.2.Multivariate Logistic regression analysis was conducted to determine the relationship between age,gender,risk factors of cerebrovascular disease,CRP level and early renal injury markers and cerebral microhemorrhage in patients with acute cerebral infarction.After adjustment for age,sex,hypertension,diabetes,hyperlipidemia,smoking,lacunar infarction,white matter loss and hypersensitive c-reactive protein,changes in early renal injury markers were still associated with microhemorrhage.The decrease in glomerular filtration rate was evaluated with an increase in the number of cerebral microhemorrhages?P=0.038,R2total=0.216?,and the increase in serum cystatin C with an increase in the number of cerebral microhemorrhages?P=0.013,R2 total=0.37??table 2-2?.3.A total of 106 patients were included in this study,which were divided into groups according to the number of CMBs:37 patients in one group had no CMBs,accounting for34.9%;There were 28 cases of mild?1⁵ microhaemorrhage?in 2 groups,accounting for26.4%.In the three groups,32 cases?6¹5 microhemorrhages?were moderate,accounting for 30.2%.The number of severe microhemorrhage?15>?in the 4 groups was 9 cases,accounting for 8.5%.The results are shown in figure 1.There were 69 patients with cerebral microhemorrhage,among which 6 patients were located in the cerebral lobe,accounting for8.7%.There were 34 cases?49.3%?in deep brain or under the act.There were 29 cases in both sites,accounting for 42%.The results are shown in figure 2.After statistical analysis,it was found that in patients with acute cerebral infarction,with the increase of the number of cerebral microhemorrhage,the glomerular filtration rate was reduced,and the level of cystatin C was also increased,which can prove the correlation between cystatin C and cerebral microhemorrhage.In patients with acute cerebral infarction,there was no significant specificity between glomerular filtration rate,cystatin C level and the location of microhemorrhage?table 2-3,table2-4?.