Study On The Etiology Of Cerebral Venous Sinus Thrombosis And Its Association With Anemia In Northeast China

Objective:To investigate the common risk factors for cerebral venous sinus thrombosis(CVST)in Northeast China,and to clarify the relationship between anemia and CVST,in order to provide reference for the diagnosis and prevention of CVST.Methods:This study used a case-control method and included 155 CVST patients admitted to the Department of Neurology,the Bethune First Hospital of Jilin University from January 2018 to June 2022 as the case group,including 70 males and 85 females.The control group consisted of 149 healthy individuals who were matched with the case group in terms of gender and age during the same period,including 76 males and 73 females.Clinical data were collected,such as gender,age,medical history,risk factors,clinical symptoms,laboratory test results,and imaging examinations for both groups.SPSS 23.0 statistical software was used to analyze the clinical data of the two groups,and to clarify the common risk factors for CVST and their correlation with anemia.Results:(1)There were a total of 155 patients in the case group,including 70 males(45.2%)and 85 females(54.8%),with a male-to-female ratio of 1:1.21.The average onset age was 38.28±14.75 years,and it was common in young people(<45 years old,105 cases,67.7%).Headache(127 cases,81.9%)was the most common clinical manifestation of CVST patients,followed by epileptic seizures(108 cases,69.6%)and limb movement disorders(45 cases,29.0%).The parietal lobe(49 cases,31.6%)was the most commonly affected part of the brain,followed by the frontal lobe(42cases,27.0%).The transverse sinus(119 cases,76.7%)was the most commonly affected vessel in venous sinus thrombosis,followed by the sigmoid sinus(114 cases,73.5%),and the inferior petrosal sinus(9 cases,5.8%)was the least affected;involvement of two or more venous sinuses was the most common.(2)In the CVST group,the percentages of number of clear factors including 0,1,and 2 or more were 29%,51%,and 20%,respectively.The most common risk factor was hyperhomocysteininemia(27.1%),followed by pregnancy and puerperium(13.5%)and use of oral contraceptive pills(OCP)(11.6%).Hyperhomocysteininemia(40%)was the most common risk factor in males,while pregnancy and puerperium(24.7%)was the most common risk factor in females.The comparison of risk factors between the male CVST group and the female CVST group showed that hyperhomocysteinmia was present in 40% of the male CVST group and 16.5% of the female CVST group,with significant differences(P < 0.05).Hematological diseases was present in 28.6% of the male CVST group and 9.4% of the female CVST group.There were significant differences in a rate of hematological diseases between the two groups(P< 0.05).Pregnancy/puerperium and use of OCP were risk factors specific to female.(3)The comparison of clinical data between the CVST group and the control group showed that there were significant differences in the risk factors for disease onset(hyperhomocysteininemia,female-specific risk factors,infection,autoimmune diseases,hematological diseases,and past unexplained thrombosis history)between the two groups.Anemia was present in 28.4% of the CVST group and 8.0% of the healthy group.There were significant differencesin the anemia rate between the two groups(P< 0.05).Gender stratification analysis showed that there were significant differences in the risk factors(female-specific risk factors,autoimmune diseases,and hematological diseases)between the female CVST group and the female control group(P < 0.05),and anemia was present in 28.2% of the female CVST group and9.6% of the female healthy group,with significant differences(P<0.05).There were significant differences in the risk factors(hyperhomocysteininemia and hematological diseases)between the male CVST group and the male control group(P < 0.05),and anemia was present in 29.4% of the male CVST group and 6.6% of the male healthy group,with significant differences(P < 0.05).(4)Association between anemia and CVST: a multivariate logistic regression analysis.The results showed that compared to normal range hemoglobin levels,anemia increased the risk of CVST(adjusted OR values were 3.745 and 95% CI,1.638-8.561).Further stratification by gender showed that in the female group,anemia increased the risk of CVST compared to normal range hemoglobin levels(OR=2.919 and 95% CI,1.035-8.233),while in the male group,anemia increased the risk of CVST(OR=5.033 and 95% CI,1.477-17.501).The risk of CVST in anemic males was slightly higher than in females(OR=5.033 vs 2.919).Conclusion:1.Hyperhomocysteininemia is the most common risk factor for CVST in Northeast China and it is also the most common risk factor for males.Pregnancy and puerperium is the most common risk factor for females.2.Anemia may be an independent risk factor for CVST in Northeast China.