Effects Of Total Burden Of Cerebral Small Vessel Disease On Neurological Function Prognosis In Cerebral Infarction Patients Caused By Large Artery Atherosclerosis

Objective: According to the comprehensive evaluation of total cerebral small vessel disease(CSVD)burden,we analyzed the effects of total burden CSVD on neurological function outcomes in cerebral infarction patients caused by large artery atherosclerosis(LAA).In order to provide theoretical basis for diagnosis and treatment of LAA stroke.Methods: A total of 148 LAA stroke patients from the TOAST(trial of ORG 10172 on acute treatment)trial were enrolled in this study from June,2016 to January,2018.The overall CSVD-related brain damage was performed according to the “total CSVD score”.Among all patients,63 were in the CSVD0-1 group and 85 were in the CSVD2-4group.The neurological deficit score was measured for all patients on the day of hospitalization using the National Institute of Health Stroke Scale(NIHSS),and the modified Rankin scale was measured on days 14 and 90 after disease onset.Correlation analysis,logistic regression and ordinal regression model were used to examine the association between CSVD global burden and clinical outcomes.Results: Among the 148 patients,63(42.57%)were enrolled in the CSVD0-1 group and 85(57.43%)in the CSVD2-4 group.Age,proportion of hypertension were significantly higher in the CSVD2-4 group than those in the CSVD0-1 group,the difference was statistically significant(P<0.05);The total CSVD burden was positively correlated to the NIHSS score on hospitalization(r=0.349,P=0.000).Multi-factor regression analysis showed that the CSVD score and NIHSS score on admission were the independent risk factors for the outcomes in LAA stroke patients(OR=3.952,95%CI=1.639~9.527,P=0.002;OR=2.067,95%CI=1.585~2.694,P=0.000).After adjustment for age,sex,and other factors,ordinal analysis results revealed that the total CSVD burden is a risk factor for clinical outcomes in LAA stroke patients on day 90(OR=3.673,95%CI=0.539~2.063;P=0.001).Conclusions: The total CSVD burden is closely associated with neurological function outcomes in LAA stroke patients.Patients with higher total CSVD scores have severer neurological deficit and poorer functional recovery on day 90 after disease onset.These results indicated that total CSVD burden is an independent risk factor for pooroutcomes in cerebral infarction patients caused by large artery atherosclerosis.