Analysis Of The Relationship Between The Total Cerebral Small Vessel Disease Burden And The Severity Of Neurological Deficit In Acute Cerebral Infarction

Objective:We aimed to investigate the risk factors of the total cerebral small vessel disease burden(CSVD)in patients with acute cerebral infarction(ACI),And the correlation between the total SVD burden and the severity of neurological deficit in patients with ACI.Method:From December 2018 to December 2019,We consecutively enrolled patients with ACI treated in the Department of Neurology of Liaoning Province Hospital.According to the National Institutes of Health Stroke Scale(NHISS score),the severity of neurological deficit after stroke was evaluated,the patients were divided into minor stroke group with NIHSS≤3 points(N=89)and the non-minor stroke group with NIHSS>3 points(N=63).Patient characteristics,risk factors,relevant blood tests were recorded,Imaging data completed within 1 week of the onset of stroke.According to the "total SVD burden Scores",the patients were divided different groups,Correlation analysis between the risk factors of total SVD burden and the severity of neurological deficit after ACI was analyzed.Results:1.Risk factors of total SVD burden in patients with ACI:Diabetes,atrial fibrillation,uric acid and NIHSS scores on admission(P < 0.05)were risk factors for total SVD burden in patients with ACI.2.In all the enrolled patients with ACI,the TOAST classification,uric acid were significantly difference in two groups(P < 0.05),MRI marks comparison: There was significant difference in 0-1 CSVD group and 2-4CSVD group(P <0.05),Logistic regression analysis showed that uric acid(OR=1.001,95%CI:0.998-1.003,p=0.019)and the total CSVD burden(OR=0.725,95%CI:0.346-1.158,p=0.039)were independent risk factors for the severity of neurological deficit in patients with ACI.The result of correlation analysis of deep white matter hyperintensity,Cerebral microbleeds,Enlarged Perivascular space,the total CSVD burden were positively correlated with the severity of neurological deficit in ACI(P < 0.05).3.In patients with acute anterior circulation cerebral infarction,hypertension,TOAST classification were significantly difference in two groups(P < 0.05),MRI marks comparison:deep white matter hyperintensity,minor-severe stenosis in carotid artery were significant difference in two groups(P <0.05),Logistic regression analysis showed that deep white matter hyperintensity was an independent risk factor for the severity of neurological deficit in acute anterior circulation cerebral infarction(OR=1.33,95%CI:0.559-3.165,p=0.039).The result of correlation analysis of deep white matter hyperintensity,enlarged perivascular space were positively correlated with the severity of neurological deficit in acute anterior circulation cerebral infarction(P < 0.05).4.In patients with acute posterior circulation cerebral infarction,TOAST classification were significantly difference in two groups(P < 0.05),MRI marks comparison:Cerebral microbleeds was significant difference in two groups(P < 0.05),Logistic regression analysis showed that microbleeds was an independent risk factor for neurological deficit severity in patients with acute posterior circulation cerebral infarction(OR=0.332,95%CI:0.111-0.992,p=0.048).The result of correlation analysis of cerebral microbleeds was positively correlated with the severity of neurological deficit in acute posterior circulation cerebral infarction(P < 0.05).Conclusion:1.Diabetes,uric acid and atrial fibrillation are the risk factors of CSVD burden in patients with ACI.2.The total of CSVD burden is correlated with the severity of neurological deficit in patients with ACI.