Investigation Of The Risk Factors For Leukoaraiosis (LA)

Cerebral white matter changes, known as leukoaraiosis(LA), arefrequently observed on computed tomography(CT) and magneticresonance imaging(MRI) brain scans of elderly individuals. It iswidely regarded it’s associated with increased age, hypertension,diabetes mellitus, lacunar infarction and history of stroke. As CTand MRI imaging technique widely used in cerebrovascular diseasein recent years,its detection has improved significantly.Although several lines of evidence suggest that the prevalenceof leukoaraiosis in patients with lacunar infarction significantlyimproved and lacunar infarction in patients with leukoaraiosis isalso found more frequently, moreover， lacunar infarction andleukoaraiosis share many common risk factors， they both areconsidered as small vessel diseases. However, the pathogenesis ofleukoaraiosis has not been found yet. By studying the risk factorsof leukoaraiosis (LA), we try to explore the relationship betweenatherosclerosis and Leukoaraiosis.I collected vascular risk factors of age， sex， smokinghistory,alcohol history,hypertension history,diabetes mellitus，stroke history，plasma lipids,coronary heart disease,carotidplaques and stenosis of471patients admitted to the neurologicaldepartment of China-Japan friendship hospital of Jilin universityfrom January to November of2013．All the patients undergonecarotid duplex ultrasound、TCD、 MRI and MRA of head and other tests．Patients were classified as normal control group(NC group，n=221)，leukoaraiosis group(LA group，n=250).Applying univariatemethod and multifactor logistic regression to analyze theassociation between LA and vascular risk factors by SPSS21.0.Further i chose193cases from both groups who had examinations toexclude carotid and intracranial vascular stenosis.Both the92patients with LA and101controls had transcranial dopplerexamination. I recorded the data of PI(pulse index) and VS(systolicblood flow velocity) of left intracranial vasculars includingmiddle, anterior, and posterior cerebral artery, vertical artery,and basic artery. Using the same method above to analyze theassociation between LA and PI and VS.The results showed that:（1）The factors such as increased age，hypertension history，diabetes mellitus hiatory, stroke history，lacunar infarction，carotid plaques and stenosis were related toLA in univariate analysis（P<O．05）.（2）In the multifactorregression analysis， it showed that increased age， lacunarinfarction and carotid plaques are independent risk factors of LA（P<O．05）.（3）Compared to NC group，the PI of left MCA、leftACA、left PCA、BA and left VA are higher in LA group,but the VSof them are lower（P<O．05）.In summary, the following conclusions:（1）Increased age，carotid plaques and lacunar infarction are independently relatedwith LA．（2）The high PI and low VS of intracranial vasculars dueto arteriosclerosis are related with LA.（3）Thus it can be presumed that the stenosis of large vessels supplying blood to brain involvesin the formation of LA, we could conclude that chronicarteriosclerosis may be the pathophysiological basis of LA.