Risk Factors Of Cerebral Hemorrhage And Its Relationship With Stroke

Purpose:With the clinical application of GRE-T2*WI and SWI, more and more micro bleeding was found, attracted the attention of people. Cerebral microbleeds and cerebral hemorrhage,cerebral infarction, vascular dementia, gait abnormalities and death are closely related,seriously affect the elderly health and quality of life. This research carries on the analysis to the related risk factors of micro hemorrhage, clinical identification of high-risk patients, for patients with active two grade prevention has certain guiding significance of micro hemorrhage.Methods:We enrolled 276 patients who underwent SWI examination, including micro hemorrhage in 47 cases, no micro hemorrhage in 211 cases, 18 cases of telangiectasis were collected at admission, age, gender, smoking, drinking, hypertension, diabetes, hypertension, most previous cerebral infarction, cerebral hemorrhage, coronary heart disease history;Determination of systolic blood pressure, diastolic blood pressure, fasting blood glucose,glycosylated hemoglobin, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, apolipoprotein A, platelet count, APTT, PT, INR, blood urea nitrogen, serum creatinine, aspartate aminotransferase, alanine amino transferase, fibrinogen, homocysteine,uric acid, vitamin B12, folic acid and other information, and improve the patient’s head magnetic resonance imaging(MRI) and transcranial Doppler( CA) and neck vascular ultrasound(TCD) examination. In this study, the micro bleeding into the thalamus and basal ganglia(DGM), cortical and subcortical region(CSC region) and subtentorial area(IT area),and count the number of microbleeds. The application of statistical methods to analyze the risk factors of micro hemorrhage in acute ischemic cerebrovascular disease group and the acute cerebral hemorrhage group, and two groups of patients with cerebral microbleeds prevalence, location and severity were compared.Results:The micro bleeding group and non bleeding group micro comparison, no significant difference in duration of diabetes, Hb A1 c, fasting blood glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, lipoprotein a, uric acid,homocysteine, etc.. Cerebral microbleeds in patients with age, hypertension, systolic blood pressure, the number of years the highest blood pressure was significantly higher than that in non cerebral microbleed group; presence of leukoaraiosis, asymptomatic lacunar infarction,hypertension, previous stroke history was significantly higher than that in non micro hemorrhage group(P < 0.05). EGFR micro brain hemorrhage group decreased percentage was significantly higher than that of non cerebral microbleed group(P < 0.05). Different risk factors for micro hemorrhage of different diseases, acute ischemic cerebrovascular disease were age, history of hypertension, hypertension, systolic blood pressure, the number of years the highest blood pressure, lacunar infarction, smoking history, drinking history, high and low e GFR and fibrinogen were positively correlated with the incidence of cerebral microbleeds(P< 0.05) in patients with acute cerebral hemorrhage; cerebral microbleed group leukoaraiosis and lacunar infarction, asymptomatic cervical atherosclerotic plaque proportion was significantly higher than that of non cerebral microbleed group(P < 0.05), the highest systolic blood pressure is greater than the non micro hemorrhage group and cerebral microbleeds group was statistically significant(P < 0.05). Two groups of patients with cerebral microbleeds in thalamus and basal ganglia area distribution, the largest number, with moderate to severe cerebral microbleeds. Small artery occlusion type of ischemic cerebrovascular disease incidence rate of CMB is highest, occur in severe microbleeds in the highest proportion(P < 0.05).Conclusion:The elderly patients with hypertension, long-term and poor control, cerebral white matter disease, asymptomatic lacunar infarction, recurrent stroke, low e GFR should be highly vigilant of cerebral microbleeds, timely magnetic resonance gradient echo sequence scan diagnosis, individualized treatment to reduce the risk of recurrent stroke. Diabetes, blood lipids, platelet count, coagulation function, liver function, high homocysteine, uric acid, folic acid may with the occurrence and development of independent microbleed.