Analysis Of Related Risk Factors Of Ischemic White Matter Lesions

Objective: This study intends to explore the occurrence of white matter ischemic lesions and the related risk factors of different severity of white matter lesions,analyze and screen out specific serological markers that may predict white matter ischemic lesions so as to prevent the occurrence of white matter lesions,intervene the existing white matter lesions in time,and provide some reference for reducing the occurrence of other brain diseases related to white matter lesions.Methods: From June 2021 to October 2022,542 patients who were hospitalized in the Brain Hospital of Xianyang Hospital of Yan ’an University were collected.The subjects were diagnosed with WMLs by head MRI,and were divided into WMLs group and control group according to whether there were white matter lesions.At the same time,the white matter lesions in the lateral ventricle and the deep white matter were scored by Fazekas visual scale.The sum of the scores was ≥3 and < 3 was mild,so they were divided into mild group(209 cases)and moderate and severe group(194 cases)according to the severity of WMLs.Collect general data of patients,and record gender,age,past history,BMI,smoking and drinking history,blood sugar and blood pressure;Laboratory indicators include RDW-SD,RDW-CV,neutrophil count,lymphocyte count,NLR,platelet,average platelet volume,hemoglobin,average hemoglobin content,average hemoglobin concentration,white blood cell count,hematocrit,average red blood cell volume,fibrinogen,lipoprotein phospholipase A2,blood lipid,uric acid,creatinine and HCY.In this study,SPSS 23.0 statistical software was used for data analysis.According to the existence of white matter lesions and their different degrees of lesions,univariate analysis was carried out,and the significant research indicators in the above statistical results were analyzed by binary Logistic regression.By adjusting the confounding factors among variables,the risk factors related to white matter lesions were finally obtained.ROC curve was used to predict the occurrence of white matter lesions and the lesions with different severity.Results:(1)A total of 542 patients were included in this study,which were divided into WMLs group(403 cases)and control group(139 cases)according to whether there were white matter lesions.According to the score of WMLs severity by Fazekas scale,it can be divided into mild group(209 cases)and moderate group(194 cases).According to the location and severity of the lesion,it can be divided into 203 cases of mild P-WMLs146 cases of moderate P-WMLs and 52 cases of severe P-WMLs.There were 221 cases of mild D-WMLs,97 cases of moderate D-WMLs and 57 cases of severe D-WMLs.(2)Comparing the data of WMLs with or without WMLs: In univariate analysis,we found that there were significant differences in age,hypertension history,systolic blood pressure,RDW-CV,RDW-SD and HCY between WMLS group and control group(P<0.05).Logistic regression analysis showed that SBP(OR=1.060 95%CI 1.032-1.084),age(OR=1.325 95% CI 1.243-1.412)and RDW-SD(or = 1.261 95% ci 1.116-1.425)were independent risk factors for WMLs.ROC curve is similar to previous results in judging the predictive ability of RDW-SD for white matter lesions.The area under the curve is0.755(95% CI 0.713-0.798,P<0.001),the sensitivity of RDW-SD for predicting WMLs is 56.6%,the specificity is 87.1%,and the optimal cutoff value of RDW-SD is 43.60 f L.(3)Comparison of WMLs data between two groups with different severity:Univariate analysis showed that there were significant differences in age,systolic blood pressure,previous history of hypertension and coronary heart disease between mild group and moderate group(P<0.05).Compared with the laboratory data,the average red blood cell volume,RDW-SD,RDW-SD,creatinine and Hcy of WMLs in moderate and severe group were significantly higher(P<0.05).Logistic regression showed that the variables with P<0.05 were age(OR=2.111 95% CI 1.770-2.519),SBP(OR=1.027 95%CI 1.003-1.051),RDW-SD(or = 1.187 95% CI 1.043-1.350)were independent risk factors for moderate and severe WMLs(P<0.05).Among them,RDW-SD also shows good judgment ability in predicting moderate and severe WMLs.The area under the curve is 0.744(95%CI 0.696-0.792,P<0.001)by analyzing ROC curve,in which the sensitivity and specificity of RDW-SD in predicting moderate and severe WMLs are 61.3% and 77.5%,and the best cutoff value of RDW-SD is 38.90 f L.Conclusions:(1)Age,hypertension and RDW-SD are independent risk factors for ischemic white matter lesions and moderate and severe white matter ischemic lesions.(2)High level of RDW-SD has certain predictive value for the occurrence of ischemic white matter lesions and moderate and severe white matter ischemic lesions.