Analysis Of Risk Factors For Cerebral Microbleeds In Patients With Acute Ischemic Stroke And Its Correlation With Hemorrhagic Transformation

Objective: Cerebral microbleeds(CMBs)are a type of cerebral small vessel disease and are considered to be a novel imaging marker.CMBs are usually caused by hypertension,which is mainly located in the deep brain region,and cerebral amyloid angiopathy,which is mainly located in the lobes.The pathogenesis of CMBs may be related to blood-brain barrier damage,atherosclerosis,inflammation,and β-amyloid deposition.Hemorrhagic transformation(HT)is one of the serious complications of acute ischemic stroke(AIS),which can lead to worsening of symptoms and poor prognosis.Blood-brain barrier disruption,ischemia-reperfusion injury,inflammatory response,and oxidative stress may be the pathogenesis of HT.There have been a number of reports examining the correlation between CMBs and HT in patients with AIS,but the conclusions vary and their relevance remains controversial.The aim of this study was to investigate the risk factors for the presence of CMBs in AIS patients and the correlation between CMBs and the occurrence of HT in AIS patients.Methods: Patients with AIS who were hospitalized in the Department of Neurology of the First Affiliated Hospital of Wannan Medical College from March 2021 to April 2022 and met the enrollment criteria were consecutively included,and a total of 217 patients with AIS were finally included in the study.Demographic characteristics,clinical features,laboratory and imaging examinations were collected from all enrolled patients.They were divided into CMBs and non-CMBs groups according to the presence or absence of CMBs,and the differences between the two groups were compared using univariate analysis,and independent risk factors for CMBs were studied using multifactor analysis.Patients were divided into HT and non-HT groups according to the occurrence of HT,and the differences between the two groups were compared using univariate analysis,and independent risk factors for HT were determined using multifactorial logistic regression analysis.Results: The study ultimately included 217 patients with AIS,of whom 101 patients had CMBs and 116 patients had no CMBs,for a CMBs prevalence of 46.5%.After univariate and multifactorial analyses of CMBs,previous stroke history(OR = 2.359,95% CI: 1.095-5.082,P = 0.028),periventricular white matter hyperintensity(WMH)score(OR = 1.715,95% CI: 1.059-2.779,P = 0.028)and deep WMH score(OR = 1.918,95% CI: 1.140-3.227,P = 0.014)were found to be independent risk factors for CMBs.A total of 31 patients developed HT and 186 patients did not develop HT,for an HT incidence of 14.3%.After univariate and multifactorial analysis of HT,the presence of strictly lobar CMBs(OR = 4.812,95% CI: 1.593-14.533,P = 0.005)and high serum lactate dehydrogenase(LDH)levels were found to be independent risk factors for HT in patients with AIS(OR = 1.006,95% CI: 1.000-1.012,P = 0.035).Conclusion: CMBs were associated with previous stroke history,periventricular and deep WMH scores.Strictly lobar CMBs and high serum LDH levels are independent risk factors for the development of HT in patients with AIS.