Analasis Of The Related Factors Of Cerebral Microbleeds In Patients With Acute Cerebral Infarction

Objectives This study was performed to detect cerebral microbleeds(CMBs)in patients with acute cerebral infarction by Susceptibility weighted imaging(SWI),to analyze the Prevalence and distribution of CMBs in this type of stroke,and investigate the risk factors of acute cerebral infarction with CMBs.Methods Cases diagnosed acute cerebral infarction patients were enrolled in Department of Neurology of Tangshan hospital workers from December 2015 to November 2016,and 124 patients were examined by SWI sequence scanning,divided into group of CMBs and group of without CMBs according to the results of SWI.All the patients were underwent T1 WI,T2WI,FLAIR,DWI,SWI sequence and MRA examination.The number and distribution of CMBs,as well as the seriousness of leukoaraiosis and the number of lacunar infarction,were recorded.the clinical data of patients were collected,including age,gender,smoking history,drinking history,Systolic blood pressure,diastolic blood pressure,history of hypertension,history of diabetes,history of stroke,carotid artery plaque and so on.Fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,prothrombin time,fibrinogen,uric acid,homocysteine and other related blood biochemistry.According to the criteria of TOAST,patients were divided into different subtype groups,and recorded the cases of CMBs in every subtype group.T-test or Manne-Whitney U test was used to compare quantitative data and Pearson chi-square test or continuity corrected chi-square test was used to analyze count data.Single-factor and multiple logistic regression analysis was applied to analyze risk factors.Spearman correlation analysis was used to analyze bidirectional ordinal variables.Results 1 There were 124 cases with acute cerebral infarction,CMBs were found in 69 patients(55.6%).the total number of CMBs is 548,with average number of 7.94.CMBs were detected most frequently in basal ganglia and thalamus(47 cases,217),followed by the lobes-subcortical(43cases,200),least in the infratentorial region(38cases,131).2 According to the TOAST criterion,with small artery occlusion type,28 cases of CMBs positive were detected(40.6%).with large artery atherosclerosis type,27 cases of CMBs positive were detected(39.1%).with cardiogenic embolism type,4 cases of CMBs positive were detected(5.8%).with unknown reason type,10 cases of CMBs positive were detected(14.5%).the incidence of CMBs in small artery occlusion type was highest.3 The systolic blood pressure,hypertension,stroke history,lacunar infarction,leukoaraiosis and carotid artery plaque were statistically significant between two groups(P<0.05).4 Single-factor logistic regression analysis showed that systolic blood pressure(OR: 1.639,95%CI: 1.323-2.030,P<0.001),hypertension(OR: 3.412,95%CI: 1.593-7.307,P=0.002),stroke history(OR: 3.269,95%CI: 1.121-9.531,P=0.030),and carotid artery plaque(OR: 2.215,95%CI: 1.066-4.606,P=0.033),lacunar infarction(OR: 3.575,95%CI: 1.174-10.867,P=0.025),leukoaraiosis(OR: 2.812,95%CI: 1.352-5.850,P=0.006)were correlated with CMBs.5 Multiple logistic regression analysis showed that systolic blood pressure(adjusted OR: 1.668,95%CI: 1.320-2.108,P﹤0.001),lacunar infarction(adjusted OR: 4.085,95%CI: 1.027-16.246,P=0.046),leukoaraiosis(adjusted OR: 2.681,95%CI: 1.153-6.232,P=0.022)are correlated risk factors for CMBs in patients with acute cerebral infarction.6 By Spearman correlation analysis,the severity of CMBs was positively correlated with grades of lacunar infarction(r=0.353,P﹤0.001)and severity of leukoaraiosis(r = 0.352,P< 0.001).Conclusions 1 CMBs were mostly located in the basal ganglia and thalamus region in patients with acute cerebral infarction.2 Among subtype of acute cerebral infarction,the incidence of CMBs in small artery occlusion type is highest.3 Systolic blood pressure,lacunar infarction and leukoaraiosis are associated with CMBs incidence in patients with acute cerebral infarction.4 The severity of CMBs was positively correlated with grades of lacunar infarction and severity of leukoaraiosis.