Study On Risk Factors For Leukoaraiosis In Vertebrobasilar Transient Ischemic Attack Patients

Objective To investigate the risk factors for leukoaraiosis(LA) in vertebrobasilar transient ischemic attack(VB-TIA) patients.Methods To select 313 consecutive VB-TIA inpatients with MRI images retrospectively(including 113 cases with intracranial vascular MRA images). The following clinical data:age, gender, ECG(RV5+SV2), carotid artery plaques, CRP, TC,HDL, TG, Hcy, LDL, UA, Hb A1 c, FA, Vit B12, leukoaraiosis(with or without), the severity of LA evaluated by ARWMC scale and variations of Willis circle and type of Willis circle variations were gathered. Risk factors for LA in VB-TIA patients were identified by clinical data above(independent variables) and with or without LA(dependent variable), using unconditional univariate and multivariate logistic regression.Independent predictive factors for severity of LA in VB-TIA patients were identified by correlation analysis and ordinal logistic regression. Whether variations of Willis circle are risk factors for LA in VB-TIA patients:variations of Willis circle were divided into four groups(Type A、Type P、Type O and Type N), The incidences of LA in each group were compared with chi-square test respectively, and then unconditional multivariate logistic regression were analyzed(risk factors for LA in VB-TIA patients and types of variations of Willis circle as independent variables,with or without leukoaraiosis as dependent variable).Results First, seven factors, age, ECG(RV5+SV2), carotid artery plaques, CRP, TC,HDL, Hcy, FA were screened out with univariate logistic regression(P<0.1), The multivariate logistic regression indicated:older age(P=0.000, OR=1.116, 95%CI:1.081~1.153), carotid artery plaques(P=0.000,OR=4.881, 95%CI: 2.510~9.493), and low serum HDL level(P=0.017, OR=3.676, 95%CI:1.267~10.638) were risk factors for LA in VBTIA patients.Second, age, gender, ECG(RV5+SV2), carotid plaque, CRP, HDL, Hcy,folic acid were screened out with correlation analysis(all P<0.1), the ordinal logistic regression indicated that age(P=0.000, OR=1.119,95%CI:1.089~1.149), HDL(P=0.042,OR=0.390,95%CI: 0.157~0.967), folic acid(P=0.006, OR=0.914, 95%CI: 0.856~0.974)and carotid plaque(P=0.000, OR=5.023, 95%CI: 2.672 ~ 9.440) were independent predictive factors for severity of LA in VB-TIA patients.Third, Type A and type O Williscircle had high prevalence of leukoaraiosis compared with type N Willis circle(P<0.05),the multivariate logistic regression indicated: Type A Willis circle(P=0.011, OR=7.768,95%CI: 1.602~37.666) and type O Willis circle(P=0.009, OR=5.236, 95%CI: 1.513~18.519) were risk factors for LA in VB-TIA patients.Conclusion Older age, carotid artery plaques,low serum HDL level and variations of Willis circle(fetal posterior cerebral artery excluded) are likely to be risk factors for leukoaraiosis in vertebrobasilar transient ischemic attack patients, while Age, HDL, folic acid, carotid plaque are likely to be independent predictive factors for LA in VB-TIA patients.