Relevant Factors For Ischemic Leukoaraiosis Lesion And Severity Analysis

Objective:Understanding the factors associated with ischemic leukoaraiosis lesion(ILA)(periventricular lesions （PVL） and deep white matter lesions （DWML）) andseverity, and to explore the possible pathology of ILA physiological mechanisms.Method: Control group choose healthy people.Leukoaraiosis group(LA)chooseILA patients.All group satisfied the inclusion criteria and exclusion criteria.The controlgroup(group1)have60cases,with male32cases and female28cases, aged27-77yearsof old, mean(51.68±11.13)years of old.ILA group was divided into simpleperiventricular lesions (group2) and periventricular lesions and deep white matterlesions(group3);Group2have78patients,with male43cases and females35cases,aged40-82years of old, mean(61.50±9.68)years of old;Group3have49patients,with27males and females22cases, aged46-88years of old, mean (66.39±10.15) years ofold. Record study general information and cranial MRI.Detecting study Fasting bloodglucose (FBG),serum total cholesterol (TC), triglycerides (TG),High densitylipoprotein-cholesterol(HDL-ch),Low density lipoprotein-cholesterol (LDL-ch),lipoprotein(a)(LP(a)), homocysteine (Hcy), Blood urea nitrogen(BUN),creatinine(Cre),uric acid (UA), cystatinC (CysC), C-reactive protein (CRP), fibrinogen (Fib), Partialthromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT).Ratingthe severity of LA with Fazekas classification method.Recording MRI shows infarcts number, location and size. All date were analyzed by SPSS20.0statistics software. Thesignificance level for bilateral test was less than0.05(P＜0.05).Results:1.Age of Group2and Group3was significantly higher than the group1(P <0.01,P <0.01), Age of Group3was significantly higher than Group2(P <0.05);The numberof cases of positive history of hypertension of Group3was significantly higher than thegroup1’s and and Group2’s (P <0.01, P <0.05);Serum Hcy levels of Group3weresignificantly higher than the group1’s(P <0.05);CysC serum levels of Group3wassignificantly higher than the group1’s and Group2’s (P <0.05, P <0.05);Plasma Fib ofGroup3was significantly higher than the group1’s(P <0.01); PT of Group2wassignificantly higher than the group1’s(P <0.05);INR of Group2was significantlyhigher than the group1’s(P <0.05);The lateral ventricle white matter lesions (PVL)rating of Group2and Group3was significantly higher than the group1’s(P <0.01, P<0.01), PVL rating of Group3was significantly higher than Group2’s (P<0.01);Subcortical white matter lesions (DWML) rating of Group3was significantlyhigher than the group1’s and Group2’s (P <0.01, P <0.01).The number of basalganglia infarction of Group2and Group3was significantly higher than the group1’s(P<0.01, P <0.01), the number of basal ganglia infarction of Group3was significantlyhigher than the group1’s(P <0.01);Quantity infratentorial infarcts of Group3wassignificantly higher than the group1’s and Group2’s (P <0.01, P <0.01).Three groupsof gender, positive history of hyperlipidemia, positive history of diabetes, positivecoronary heart disease, smoking and drinking history constitutes have not significantdifference than those without.Three groups of serum FBG, TC, TG, HDL-ch, LDL-ch,LP (a), BUN, Cre, UA, CRP levels and plasma TT, APTT were no significantdifference.Quantity of subcortical infarcts among the three groups have no significantdifferences.2.Group2analysis of risk factors. Univariate Logistic regression analysis: Age(OR=1.103), PT (OR=1.923), INR (OR=566.985)3indicators into the regression equation, they were statistically significant (P <0.01; P <0.01; P <0.05). Logisticregression analysis: Age (OR=1.103) were statistically significant (P <0.05).3. Group3analysis of risk factors. Univariate Logistic regression analysis: Age(OR=1.157), positive history of hypertension (OR=0.176), CysC (OR=105.793),Hcy (OR=1.087), Fib (OR=2.380), PT (OR=1.727)6indicators into the regressionequation, they were statistically significant (P <0.01; P <0.01; P <0.01; P <0.05; P<0.01; P <0.05). Logistic regression analysis: Age (OR=1.154), positive history ofhypertension (OR=0.147), PT (OR=2.418) were statistically significant (P <0.01; P<0.01; P <0.05).4.The total periventricular lesions (TPVL) analysis of risk factors.UnivariateLogistic regression analysis: Age (OR=0.000), positive history of hypertension (OR=0.369), CysC (OR=18.196), Hcy (OR=1.059), Fib (OR=1.908), PT (OR=1.842),INR (OR=331.257)7indicators into the regression equation,they were statisticallysignificant (P <0.01; P <0.01; P <0.05; P <0.05; P <0.05; P <0.01; P <0.05). Logisticregression analysis: Age (OR=1.118)was statistically significant (P <0.01; P <0.05).5.There was a positive correlation between age and SPVL（r=0.226，P＜0.05).6. CysC, Hcy, Fib have no correlation with DWML.7.There was a positive correlation between age and TPVL（r=0.326，P＜0.01).8.Age, CysC, Hcy have the positive correlation with overall ratings (F rating)(r=0.315，P＜0.01；r=0.249，P＜0.05；r=0.187，P＜0.05). F rating multivariatelinear regression analysis: F rating=-0.868+3.016CysC+0.764hypertension.Conclusion:1SPVL’s risk factors have Age, PT and INR.Age is the independent risk factor ofSPVL. Age was positively correlated with SPVL rating and it can reflect the severity ofSPVL.2DWML’s risk factors have Age, hypertension, serum CysC level andPT.Hypertension is the independent risk factor of DWML.These indicators have nocorrelation with DWML and they are not reflect the severity of DWML. 3TPVL’s risk factor have Age, hypertension, serum Hcy, CysC levels, plasma Fiblevels, blood PT and INR; Age is the independent risk factor of TPVL.Age is positivelycorrelated with TPVL rating.Age can reflect the severity of TPVL. Age, serum Hcy,CysC level’s positively correlated with the ILA.They can reflect the severity of the ILA.The largest impacted of ILA’s formating are the CysC and hypertension.