Risk Factors For Cerebral Microbleeds In Patients With Acute Ischemic Stroke

Objective To investigate the relation of kidney function,serum lipid levels,white matter hyperintensity(WMH)and lacune to the presence and severity of cerebral microbleeds in patients with acute ischemic stroke 。Methods This study is based on 255 consecutive patients admissed in 14 days with acute ischemic stroke.From January 2014 to December 2016,a cross-sectional study was conducted at the Department of Neurology of the First Hospital of Fujian Medical University.MRI was performed at 3.0 T(included SWI).According to the number of lesions,the severity of CMBs and lacune were classified,also the anatomical position and severity of WMH were classified according to Fezakas scale.According to the number and location,CMBs were divided into 8 subgroups.The kidney function markers(e GFR and cystatin C levels),serum lipid levels(LDL-C and HDL-C),WMH and lacune were compared between subgroups.Risk factors of CMBs were analyzed using multivariate Logistic regression model.Results In this study,a total of 140 subjects(54.9%)had ≥1 CMB.In the infratentorial areas` CMBs,the proportion of low e GFR levels in the moderate and severe group was higher than that in the mild group(P = 0.018).Multivariate Logistic regression analysis showed :(1)the low e GFR level was an independent risk factor for the moderate and severe group(odds ratio,3.925;95% confidence interval,1.292-11.928;P=0.016);(2)Hypertension was an independent risk factor for infratentorial CMBs(odds ratio,5.038;95% confidence interval,1.919-13.223;P<0.001);(3)WMH and lacune were the independent risk factors for the presence and severity of CMBs in each area(all of them,odds ratio >1.5;P<0.001);(4)In the moderate and severe group of PVH(odds ratio,2.687;95% confidence interval,1.504-4.801;P=0.001),the moderate and severe group of DWMH(odds ratio,2.357;95% confidence interval,1.354-4.102;P=0.002)and hypertension(odds ratio,2.042;95% confidence interval,1.049-3.974;P=0.036) were independent risk factors of CMBs.(5)Cystatin C levels and serum lipid levels(LDL-C and HDL-C)were not independent risk factors for the presence and severity of CMBs in each site(all of them,P>0.05).Conclusion(1)In the infratentorial areas,low e GFR level was an independent risk factor for the moderate and severe CMBs group.(2)Hypertension was an independent risk factor for CMBs.(3)Lacune and WMH were independent risk factors of CMBs in each site.(4)Cystatin C levels and serum lipid levels(LDL-C and HDL-C)were not independent risk factors for CMBs in each site.