The Correlation Between Cerebral Microbleeds And Homocysteine As Well As Risk Factors Analysis With Ischemic Stroke

Objective To investigate the correlation between serum homocysteine levels and the other risk factors with the ischemic stroke patients with cerebral microbleeds(CMBs),in order to provide a theoretical basis for the secondary prevention of CMBs with ischemic stroke.Methods 102 cases of hospitalized patients with ischemic stroke from October2015 to December 2016 in Liaoning People's Hospital were selected.All patients met the following inclusion criteria: 1.patients aged between40 and 85 years old;2. Ischemic stroke diagnostic criteria: refer to the 2014 China guide for diagnosis of acute ischemic stroke 3.CMBs diagnostic criteria: refer to the cerebral small vascular study of imaging diagnostic criteria published in the Lancet Neurology by2013 international vascular change neuroimaging standard report group;4.For the first time,or a history of cerebral infarction,but before the onset m RS score 2 points or less;5.patients had serum homocysteine test within 24 hours of admission.Exclusion criteria: 1.History of cerebral hemorrhage,subarachnoid hemorrhage,Intravenous thrombolysis,brain tumor,brain injury,blood system disease,immune disease,and thyroid disease;2.Recently took some drugs affecting serum homocysteine levels such as vitamin,folic acid and so on 3.severe heart,lung,liver,and renal dysfunctions;4.Inability to cooperate in the MRI examination.General clinical information,vascular risk factors,and the blood test results were collected.Applicate the circulating enzymatic method for determination of serum homocysteine concentration,using the Hitachi 7080 automatic biochemical analyzer and its accessory kit.Cranial MRI was performed using a 3.0-T MRI scanner from America GE Company.The following sequences were obtained: T1-weighted sequence,T2-weighted sequence,T2 Fluid-attenuated inversion recovery(T2-FLAIR),DWI,and SWI(TR,28 ms;TE,20 ms;FOV,230 × 173 mm;matrix,320 × 221;slice thickness,3 mm).Hcy ? 15umol/L was defined as hyperhomocysteinemia.According to the presence of CMBs patients were divided into CMBs+ group and no CMBs group.We did statistical analysis between two groups.Multivariate Logistic regression analysis was used to determine the CMBs risk factors.Finally,we analyzed the relativity between homocysteine and CMBs distribution.The cut-off value for statistical significance was 0.05.Results1.A total of 102 patients with ischemic stroke were enrolled,44 had microbleeds with an incidence of 43.14%.CMBs lesion was found in deep brain regions in 20patients(45.45%),in cortico-subcortical regions in 13 patients(29.55%),in both regions in 11 patients(25.00%).2.Univariate analysis showed that age,gender,hypertension,lacunar infarcts,smoking,homocysteine,cholesterol and high density lipoprotein cholesterol was risk factors of CMBs(P<0.05).3.Logistic regression analysis showed that age,hypertension,lacunar infarcts,homocysteine,and cholesterol were independent risk factors of CMBs(P<0.05).4.Analysis of the pertinence between distribution of CMBs and hyperhomocysteinemia showed that high homocysteine levels were more frequent in patients with deep CMBs,there was statistically significance(X2=11.198,P=0.003).Conclusion Age?hypertension?lacunar infarcts?homocysteine and reduced cholesterol are the independent risk factors for ischemic stroke with CMBs.High homocysteine levels in patients with ischemic stroke are more likely to have deep CMBs.