A Study On Influencing Factors Of Total Burden Of Cerebral Small Vessel Disease In Patients With Acute Ischemic Stroke

Objectives 1.This paper aims to explore the relationship between the overall burden of cerebral small vessel disease and intracranial macroangiopathy in patients with acute cerebral infarction and to study its influencing factors,all with a view to provide a new theory basis for post-clinical evaluation of stroke patients with intracranial vascular stenosis;2.By analyzing the relationship between hippocampal atrophy and intracranial macroangiopathy in patients with acute ischemic stroke,this paper aims to provide a new theory basis for cerebral infarction patients with cognitive dysfunction;3.By analyzing the relationship between the overall burden score of cerebral small vessel disease,the degree of intracranial vascular stenosis,and hippocampal atrophy grading,this paper aims to provide new clues for the early detection and intervention of vascular dementia?Methods A retrospective analysis was conducted on patients,with acute cerebral infarction,who have completed HR magnetic resonanceimaging and received a treatment in the First Affiliated Hospital of University of South China from July 2016 to January 2018.The “total SVD score method” was used to analyze the overall burden of cerebral small vessel disease(score ranged from 0 to 4 according to the severity of the burden).The degree of intracranial stenosis was evaluated by NASCET and divided into 4 groups according to the severity of intracranial vascular stenosis(“0” represents no stenosis of intracranial vessels,while “1” represents stenosis of intracranial vessels ?50%;“2”represents stenosis of any one of intracranial vessels>50%,while “3”represents intracranial ?2 vessels stenosis>50%).The “MTA grading”was used to classify the hippocampus atrophy(range from 0-4).At the same time,the patients' name,gender,age and other general conditions and risk factors for cerebrovascular disease were recorded(such as prevalence of hypertension,diabetes,hyperlipidemia and heart disease).The data were analyzed using SPSS18.0 statistical software,non-paramet-ric test,Chi-square test,Spearman rank correlation analysis and other methods for statistical analysis,deviation refers to P <0.05,all this study was considered to have statistical significance.Results 1.A total of 266 patients included 187 males and 79 females,with a median age of 64 ± 17 years old.The overall burden of cerebral small vessel disease was scored 0,1,2,3 and 4,which correspond to the number of 24,40,76,75 and 51 respectively.There was no significantdifference in gender,diabetes,hyperlipidemia and heart disease prevalence among the groups in the total burden of cerebral small vessel disease(P>0.05),There was a lack of statistical significance.There was a significant difference in the age and the prevalence of hypertension between the groups in the total burden of cerebral small vessel disease(P<0.05),with statistical significance;2.The overall burden score of cerebral small vessel disease was positively correlated with the severity of intracranial vascular stenosis(r=0.474,P=0.000),with statistical significance;3.The numbers of hippocampus atrophy grade 0,1,2,3 and4,which correspond to the number of 110 ? 99 ? 41 ? 14 and 2respectively.There was a significant difference in the age and the prevalence of hypertension between the groups of hippocampal atrophy grade(P <0.05),with statistical significance,but there was no significant difference in the prevalence of diabetes,hyperlipidemia and heart disease among the groups of hippocampal atrophy grade(P > 0.05),with no statistical significance;4.There was a correlation between hippocampal atrophy and intracranial vascular stenosis(r = 0.232,P = 0.000),which was considered to have statistical significance;5.There was a significant correlation between the overall burden of cerebral small vessel disease and the grade of hippocampus(r = 0.443,P = 0.000),was considered to have statistical significance?Conclusions:1.The overall burden of cerebral small vessel disease isparallel to the degree of stenosis of large vessels in the brain,Age and hypertension are the influencing factors of the overall burden of cerebral small vessel disease;2.The degree of hippocampal atrophy and intracranil Macrovascular disease are positively correlated,while age and hypertension are proved to be the influencing factors;3.The overall burden of cerebral small vessel disease and hippocampal atrophy are related,and both are associated with intracranial macrovascular disease.