| Objective To investigate the risk factors for vascular cognitive impairment, the riskfactors for cerebral microbleeds(CMBs) and the effect of cerebral microbleeds oncognitive function in patients with ischemic stroke.Methods The date of patients with ischemic stroke over the age of50werecollected.Using magnetic resonance imaging evaluated cerebral microbleed, whitematter damage and infarction volume.The Montreal cognitive assessment(MoCA) scaleand Alzheimer’s disease assessment scale-cognitive were used to evaluate cognitivefunction. Hamilton depression scale (HAMD) were used to evaluate the depressionstatus in order to exclude the patients with depression.The patients with ischemic strokewere divided into either a cognitive impairment group or a non-cognitive impairmentgroup according to the scale evaluation results.The demographic datas and clinicalcharacteristics in both groups were compared,and the multivariate logistic regressionanalysis was used to look for the independent risk factors for cognitive impairment inpatients with ischemic stroke.The patients with ischemic stroke were divided into eithera CMB group or a non-CMB group according to the magnetic resonance imagingresults.The demographic datas and clinical characteristics in both groups werecompared,and the multivariate logistic regression analysis was used to look for theindependent risk factors for CMB in patients with ischemic stroke.TThe spearman rankcorrelation method was used to analyse the degree of CMBs,total score of MoCA,and the correlations of all cognitive domains scores.Result A total of169patients with ischemic stroke were included in the study. Therewere80patients in the cognitive impairment group and89patients in the non-cognitiveimpairment group.34patients had CMBs and135patients had no CMBs.The age wasolder (71.99±6.01years vs.64.47±6.15years;t=8.014,P=0.000), years of education wasfewer(4.51±1.534years vs.4.51±1.534years;t=8.023,P=0.000),systolic blood pressurewas higher(156.19±17.527mmHg vs.142.04±16.028mmHg,1mmHg=0.133kpa;t=5.479,P=0.000),scale of white matter lesion was higher(7.33±2.043vs.4.39±2.167;t=8.951,P=0.000),cerebral infarction volume was larger (7123.8±1587.11mm3vs.5628.4±1017.76mm3;t=7.201,P=0.000),proportion of the patients with historyof previous strok or transient ischemic attack was higher(46.2%vs.28.1%;X~2=5.982,P=0.014),and number of CMBs was larger (X~2=17.565,P=0.000)in thecognitive impairment group.Multivariate logistic regression analysis showed that theage(odds ratio[OR]1.115,95%confidence interval [CI]1.013-1.227; P=0.026), lowlevels of education (OR0.490,95%CI0.325-0.793; P=0.001),systolic bloodpressure(OR1.048,95%CI1.014-1.083; P=0.005), degree of white matter changes(OR2.044,95%CI1.466-2.851; P=0.000)and volume of cerebral infarction (OR2.204,95%CI1.386-3.503; P=0.001)were all the independent risk factors for cognitive impairmentin patients with ischemic stroke.Compared to the non-CMB group,the age was older(72.06±5.59years vs.67.01±7.15years;t=4.427,P=0.000), years of education wasfewer(3.97±1.381years vs.6.25±2.317years;t=7.367,P=0.000),systolic blood pressurewas higher(155.03±20.159mmHg vs.147.16±17.322mmHg;t=2.290,P=0.023),scale ofwhite matter lesion was higher(7.03±2.139vs.5.47±2.591;t=3.247,P=0.001),cerebralinfarction volume was larger (6968.5±1507.37mm3vs.6177.0±1477.08mm3;t=2.735,P=0.007),and proportions of hypertension (82.4%vs.41.5%;X~2=18.149,P=0.000),hyperlipidemia(88.2%vs.39.3%;X~2=26.067,P=0.000), history of previous stroke or transient ischemic attack (70.6%vs.28.1%;X~2=21.061,P=0.000) and coronary heartdisease (94.1%vs.45.2%%;X~2=26.278,P=0.000) were higher in the CMB group.Multivariate logistic regression analysis showed that age(odds ratio[OR]1.132,95%confidence interval [CI]1.045-1.226; P=0.002),hypertension(OR3.613,95%CI1.234-10.577; P=0.019),high blood cholesterol(OR5.055,95%CI1.756-14.549;P=0.003) and degree of white matter changes(OR1.246,95%CI1.028-1.512; P=0.025)were all the independent risk factors for CMB.The MoCA total scores(M[Q1～Q3];24[24～25] vs.28[27～28];Z=-7.092,P=0.000)as well as the scores ofattention(6[5～6] vs.6[6～6];Z=-2.502,P=0.012),abstraction(2[1～2] vs.2[2～2];Z=-2.382,P=0.017), and visuoexecutive(2[1～2] vs.4[4～5];Z=-7.321,P=0.000) inthe CMB group were significantly lower than those in the non-CMB group.Thespearman rank correlation test showed that the grade of CMB was negatively associatedwith the MoCA total score(rs＝-0.879,P＝0.000) as well as the score of visuoexecutive(rs＝-0.895,P＝0.000),attention(rs＝-0.337,P＝0.005), and abstraction(rs＝-0.333,P＝0.006).Conclousions The age,years of education, systolic blood pressure,degree of white matterchanges,and volume of cerebral infarction are the risk factors for vascular cognitiveimpairment.Age,hypertension,high blood cholesterol,and degree of white matterchanges are the risk factors for cerebral microbleed.The visuospatial executivedysfunction,attention and abstract thinking decline significantly in ischemic strokepatients with CMBs.CMBs and their numbers are closely associated cognitiveimpairment.The more the CMB numbers are,the more obvious the cognitive impairmentwill be. |
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