Investigation And Analysis Of Clinical Data Of Hospitalized Elderly Patients With Silent Lacunar Infarction

Objective:To investigate and analyze the clinical data of elderly patients with silent lacunar infarction(SLI).Methods : Select elderly elderly patients with silent lacunar infarction who were admitted to the First Affiliated Hospital of Shihezi University from August 2018 to June 2018.Collect basic patient information,test indicators,magnetic resonance imaging(MRI)results,geriatric syndrome,chronic disease,cognitive impairment,sleep disorders,drug use.Results:1.Among the 355 patients with silent lacunar infarction,there were 180 males and 175 females aged from 65 to 95 years.43.94% patients had smoking history,39.44% patients had drinking history,body mass index,homocysteine(HCY)and systolic blood pressure were higher than normal.The proportion of smoking history and HCY level of male patients were higher than that of female patients,and the levels of high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC)and systolic blood pressure in female patients were higher than that of male patients(P<0.05).2.The main symptoms were dizziness(59.43%),chest distress(12.96%),chest pain(4.79%)and headache(4.23%).3.The majority of the 355 patients were multiple infarcts(63.38%),and 36.62% were single infarcts.The most common site of infarction is 201 patients in radiation crowns(56.62%),171 in the basal ganglia(48.17%),133 in the lateral ventricular anteroposterior angle(37.46%).4.Of the patients,there were 52.94% had cognitive dysfunction.The proportion of patients with temporal lobe,occipital lobe,frontal lobe,parietal lobe and brainstem infarction was higher,all of them were over 80%.There were significant differences in visual spatial executive ability,naming,attention,language,abstraction,delayed recall,orientation score and montreal cognitive assessment(Mo CA)total score among different infarction sites(P < 0.05).Visual space and executive function impairment were most common in patients with parietal and occipital infarction;named function impairment was most common in patients with occipital infarction;attention disorder was most common in patients with parietal and frontal infarction;language disorder was most common in patients with temporal infarction;abstract ability disorder was most common in patients with frontal and parietal infarction;delayed recall disorder was most common in patients with marginal lobe infarction.Disorientation is most common in patients with frontal lobe,parietal lobe,brainstem,limbic lobe infarction.5.There were 58.59% patients were self-care providers,73.37% patients had sleep disorders.6.The most common types of geriatric syndrome were visual impairment 88.17%,hearing impairment 66.20%,falling risk 59.72%,constipation 34.65%,multiple medication 29.86%,urinary incontinence 29.29%,chronic pain 27.60%,fecal incontinence 4.23%,pressure sore risk 3.66%.The prevalence of fall risk,urinary incontinence,fecal incontinence,and multiple medication increased with age(P< 0.05).1.12% of the patients had no geriatric syndrome,and 90.69% had two or more geriatric syndromes.7.The proportion of patients with hypertension(81.69%),coronary heart disease(51.27%),osteoarthritis(36.06%),hyperlipidemia(34.37%),and diabetes(29.86%)was higher.Compared with men,women have higher rates of hypertension,hyperlipidemia,and osteoarthritis(P<0.05).There were 29.86% patients had metabolic syndrome,98.87% patients had two or more comorbidities,87.32% patients had three or more comorbidities.The proportion of patients with 3 or more comorbidities increases with age(P < 0.05).8.The proportion of patients using antihypertensive drugs,hypoglycemic drugs,antiplatelet drugs,and statins before admission was 56.90%,18.59%,32.70%,and25.60%.9.One year after the patient was discharged,the patients were followed up.And 36 patients were lost to follow-up,115 were rehospitalized(36.05%),25 had symptomatic lacunar infarction(7.84%),and 9had recurrent stroke(2.82%).Two patients died(0.48%).And the proportion of patients with symptomatic lacunar infarction who did not take antiplatelet drugs was higher than those who took antiplatelet drugs(11.32% vs 4.38%),the difference was statistically significant(P <0.05).Conclusion:1.The majority of elderly patients with silent lacunar infarction were multiple infarcts,and the most common infarct site was radiation crown,which may be related to the asymptomatic manifestations of the patients.The incidence of cognitive impairment is high in patients with SLI,and the incidence of cognitive impairment and types of cognitive impairment are closely related to the location of infarction.2.The high proportion of patients with hypertension,coronary heart disease,diabetes,hyperlipidemia,smoking,hyperhomocysteine and metabolic syndrome may be related to the occurrence of silent lacunar infarction.The use rate of antiplatelet drugs and statins in silent lacunar infarction patients is low,and the treatment of silent lacunar infarction is mainly to control the risk factors of disease.