Observation And Analysis Of Cerebral Microbleeds In Patients With Acute Minor Stroke

Objective To observe the incidence,number and location of cerebral microbleeds(CMBs)in acute minor stroke patients and to analyze the relationship between CMBs and the risk factors of cerebrovascular disease as well as TOAST etiological subtype.Methods A total of 188 patients with acute minor stroke were recruited.The following data were recorded: age,gender,hypertension,diabetes,coronary artery disease,atrial fibrillation,the history of smoking,the history of antiplatelet and/or anticoagulation therapy,the results of blood test including fast glucose,lipids,homocysteine,fibrinogen,serum creatinine and serum uric acid.Neurological deficit,brain lacunar infarction and leukoaraiosis were evaluated.TOAST etiological subtype was conducted.CMBs was observed on the sequence of susceptibility weighted imaging.All the recruited minor stroke patients were classified into three groups according to the number of CMBs: no CMBs,1-4 CMBs,?5 CMBs.And all the patients were classified into lobar and deep/mixed groups according to the location of CMBs.Comparation was performed among the above groups on the data of demography,risk factors of cerebrovascular disease,the history of antiplatelet and/or anticoagulation therapy,the results of blood test,neurological deficit,brain lacunar infarction,leukoaraiosis and TOAST etiological subtype.Results Of the 188 patients,103 patients had no CMBs(54.79%)and 85 patients(45.21%)had CMBs.In the patients with CMBs,there were 52 patients(27.66%)with 1-4 CMBs and 33 patients(17.55%)with CMBs ? 5,22 patients with lobar(11.70)and 63 patients with deep/mixed(33.51%)CMBs.Serum uric acid(P=0.005),brain lacunar infarction(P=0.001),leukoaraiosis(P=0.001),and TOAST etiological subtype(P=0.044)were statistically significant different among the patients with no CMBs,1-4 CMBs,and ?5 CMBs.Multivariate logistic regression analysis showed that serum uric acid(OR=1.01,95% CI: 1.00-1.01,P=0.018),severe leukoaraiosis(OR=7.77,95% CI,2.39-25.25,P =0.001)were independent risk factors for 1-4 CMBs;that serum uric acid level(OR=1.00,95% CI: 1.00-1.01,P=0.016),moderate leukoaraiosis(OR=5.13,95% CI,1.66-15.90,P=0.005),severe leukoaraiosis(OR=30.6,95% CI: 7.85-119.35,P<0.001)and stroke of small artery occlusion(OR=8.43,95% CI: 2.10-33.82,P=0.003))were independent risk factors for ?5 CMBs,with no CMBs as control.Correlation analysis showed that the number of CMBs was positively correlated with the level of serum uric acid(r=0.24,P=0.01)and the severity of leukoaraiosis(r=0.392,P<0.001).Body mass index(P=0.03),the level of serum uric acid(P=0.007),brain lacunar infarction(P=0.001),and the severity of leukoaraiosis(P = 0.001)were statistically significant different among the patients with no CMBs,lobar CMBs and deep/mixed CMBs.Multivariate logistic regression analysis showed that the level of homocysteine(OR=1.04,95% CI: 1.00-1.08,P=0.045),the severe leukoaraiosis(OR=9.92,95% CI: 2.38-41.41,P=0.002)were independent risk factors for lobar CMBs;serum uric acid(OR=1.01,95% CI: 1.00-1.01,P=0.009),moderate leukoaraiosis(OR=2.73,95% CI: 1.17-6.35,P=0.020),severe leukoaraiosis(OR=11.95,95% CI: 3.77-37.84,P<0.001),stroke of small artery occlusion(OR=2.35,95% CI: 1.01-5.44,P =0.046)were independent risk factors for deep/mixed CMBs,with no CMBs as control.Conclusion The incidence of CMBs in patients with minor stroke was 45.21%,and the incidence of ?5 CMBs was 17.55%.The incidence of ?5 CMBs and deep/mixed CMBs was higher in patients with minor stroke of small artery occlusion.The number of CMBs was positively correlated with the level of serum uric acid and the severity of leukoaraiosis.