Analysis On Risk Factors Of Cerebral Microbleeds And Its Relation With Cognitive Function In Patients With Cerebrovascular Disease

Part? Analysis on risk factors of cerebral microbleeds in patients withcerebrovascular diseaseObjective: To investigate the related risk factors of cerebral microbleeds(CMBs)in patients with cerebrovascular disease,and to provide theoretical basis for the prophylaxis and treatment of CMBs.Methods: Continuty to recruit the patients who had cerebrovascular disease in the Neurology Department of the Hebei Medical University from January 1,2015 and January 1,2017.Their information were recorded,which including general demographic data,personal history,previous medical history,test results,et al.All the patients enrolled were examined using MRI scanners including T1 WI,T2WI,FLAIR,DWI,MRA,SWI.The SWI results of the patients with CMBs were evaluated using the Microbleed Anatomical Rating Scale(MARS),and Leukoaraiosis severity was assessed using the Fazekas scale.The patients enrolled were divided into two groups according to the existence of CMBs or not,analyzed the risk factors of CMBs,respectively explored the correlation between CMBs and Fazekas scale score as well as lacunar infarction,and compared the risk factors of CMBs in different position.Results:1 Basic situation:Altogether enrolled 164 patients,among these patients,98 were found to exhibit CMBs(CMBs incidence of 59.8%).The detection rate of CMBs in different diseases were as follows: 43.3% in non-acute cerebrovascular disease,63.9% in acute cerebral infarction,85.7%in acute cerebral hemorrhage,100% in hemorrhagic transformation.The incidence of CMBs in different brain area were,in order,lobar(46.3%),deep(38.4%)and infratentorial regions(15.3%).2 Univariate and multivariate analysis showed that age(OR=1.069,95%CI:1.008-1.133),hypertension(OR=3.472,95% CI:1.243-9.696),leukoaraiosis(OR=2.235,95% CI:1.345-3.715),lacunar infarction(OR=1.589,95%CI:1.01-2.499)were independently associated with CMBs.3 Correlation analysis showed that the number of CMBs has positive correlation with severity of leukoaraiosis(r=0.564,P<0.001)and the number of lacunar cerebral infarcts(r=0.762,P<0.001).4 The risk factors of CMBs in different position: The patients who exhibited strictly lobar CMBs were the oldest,and had the largest number of lacunar infarction.The patients who exhibited deep or infratentorial CMBs had the highest percentage of hypertension.The patients who exhibited mixed CMBs had the highest Fazekas scale score.Conclusions: Age,hypertension,leukoaraiosis,lacunar infarction were the independent risk factors of CMBs.And the severity of CMBs was positively correlated with the severity of leukoaraiosis and lacunar infarction.Part ? The relation between cerebral microbleeds and cognitive function in patients with cerebrovascular diseaseObjective: To explore the relationship between CMBs and cognitive function in patients with cerebrovascular disease.Methods: We selected the patients from the Part?as the research object.The baseline information such as age,gender,education level,severity of leukoaraiosis,the number of lacunar infarction,was similar between CMBs positive group and negative group.The cognitive function of patients enrolled was measured by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(Mo CA).The differences of the total scores of cognitive function,scores of different cognitive domains and the rates of dementia were compared and analyzed in patients with or without CMBs and in patients with CMBs in different location.Results:1 Basic situation:A total of 96 patients who had cerebrovascular disease were examined in the study.Of these patients,51(53.1%)had CMBs.2 The relation between CMBs and cognitive function: Compared with CMBs negative group,the scores of Mo CA,visuospatial executive functions,attention,delayed recall were lower and the rates of dementia were higher in CMBs positive group.(P<0.05)3 The effects of different location of CMBs on cognitive function:Strictly lobar CMBs were associated with lower scores of Mo CA and worse performance in all cognitive domains.(P<0.05)The deep or infratentorial CMBs were insignificantly correlated with cognitive function.(P>0.05)Conclusions: CMBs,especially strictly lobar CMBs,could lead to global cognitive decline and even dementia in patients who had cerebrovascular disease.In addition,CMBs was most closely related with visuospatial executive functions,attention and delayed recall.