The Association Between Inflammation Indexes And Cerebral Venous Thrombosis

Background:Cerebral venous thrombosis(CVT)is a little-known and rare cause(nearly 1%)of stroke.It often occurs in young adults,especially in women of childbearing age.The male-to-female ratio is 1:3.In recent years,the incidence of CVT has increased.In 2011,the annual incidence of CVT through autopsy was 2-5 cases per million,while recent studies have shown that the annual incidence may reach 12-15 cases per million.There are many susceptible factors of CVT,which are considered to be related to the three factors of Virchow,namely,blood stasis,the change of blood vessel wall and the change of blood composition.The risk factors can be divided into two categories:inflammatory and non-inflammatory factors,in which the mechanism of inflammation was considered to be closely related to the occurrence of CVT.Part Ⅰ:Analysis of clinical characteristics of patients with cerebral venous sinus thrombosis.Objective:We aimed to raise the awareness of CVT by exploring the clinical characteristics(epidemiological characteristics,possible predisposing factors,risk factors,clinical manifestations,imaging changes and prognosis)of CVT through retrospective study,combined with previous literature reports,so that we can reduce misdiagnosis and missed diagnosis,and achieve the goal of "early detection,early diagnosis and early treatment".Methods:A total of 155 CVT patients were admitted in Shenzhen Baoan People’s Hospital the third affiliated Hospital of Sun Yat-sen University and Zhujiang Hospital,from 2012 to 2020.The case data of the patients were collected,collated and analyzed,including age,sex,time of onset,clinical symptoms;time from admission to diagnosis,risk factors,imaging features,hospitalization days,discharge outcome and short-term prognosis.Results:CVT mainly occurs in young adults,especially in women of childbearing age.Headache is the most common clinical symptom,and most patients had subacute onset.The location of thrombus was mainly found in the parietal sinus,superior sagittal sinus and sagittal sinus.Anticoagulation was the main treatment and the prognosis of most patients with CVT were good.Part Ⅱ:The Association between Cerebral Venous Thrombosis and InflammationObjective:In this study,the objective was to explore the correlation between inflammation and CVT and seek a new diagnosis index to reduce the occurrence of misdiagnosis,missed diagnosis and delayed diagnosis of CVT.Methods:The samples of 150 participants(including 90 CVT and 60 controls)with similar baseline characteristics were collected in this retrospective study.The NLR,PLR,MHR,SII and file records were employed to compare CVT patients with the control group.Results:The levels of NLR(3.93[2.27,7.87]vs.1.65[1.31,2.06],P<0.001),PLR(149.52[98.39,198.82]vs.107.34[83.31,129.47],P<0.001),SII(382.45[273.51,520.92]vs.896.84[559.89,1591.87],P<0.001)and MHR(0.51[0.40,0.64]vs.0.41[0.29,0.53],P=0.001)were significantly higher in the CVT group.After multivariate logistic regression analysis,the SII degree(13.136,[5.675,30.407],P<0.001)and MHR degree(2.620,[1.123,6.113],P=0.026)were found as independent predictors of CVT.Conclusion:NLR,PLR,SⅡ,and MHR may be able to predict the diagnosis of CVT which confirmed that inflammation played an important role in CVT.