Correlation Between Cerebral Microbleeds And Cognitive Function Of Cerebral Small Vessel Disease

Objective:Study common risk factors of CMBs and analyze their mechanisms.Identify whether there is a link between cognitive dysfunction CI and CMBs.Methods:Collecting patients with cerebral small vessel disease who were admitted to the inpatient department and outpatient department of neurology of the Second Hospital of Hebei Medical University from September 2015 to September 2018.And patients with combined cerebral microhemorrhage were treated as the cerebral microhemorrhage group,while patients without combined microhemorrhage were treates the control group,with 60 cases in each group.Collecting basic clinical data such as gender,education level,hypertension,age,diabetes,coronary heart disease,hyperlipidemia,smoking,and improving the patient's head(DWI+MRI+MRA+SWI),electrocardiogram,cervical vascular ultrasound,Blood routine,biochemical total and hemocysteine were compared between the two groups.The scores of the two groups were compared by MMSE and MoCA.The cerebral microhemorrhage group was divided into grades 1 to 3 according to the number of lesions,and the differences in cognitive ability scores between the three groups were compared.Meanwhile,the cognitive function differences of patients with different degrees of cerebral microhemorrhage were evaluated.CMBs were grouped according to different anatomical locations and their distribution characteristics were analyzed.Results:1.A total of 120 patients were recruited in this study,including 60 patients in the microhemorrhage group,including 42 males(70%)and 18 females(30%),aged 43-78 years,with an average age of 68.9±25.9 years.The control group included 39 males(65%)and 21 females(35%),aged 38-75 years,with an average age of 56.9±18.9 years.The average age of the microhemorrhage group was higher than that of the control group,and there was no difference in the inclusion of multivariate regression analysis.In terms of gender,Pearson chi-square test showed no difference between the two groups(P > 0.05).In this study,there were 52 cases(86.7%)of hypertension in the microhemorrhage group and 40 cases(66.7%)of hypertension in the control group,and the multivariate regression analysis was statistically significant(P < 0.05).There were 7 cases of diabetes in the microhemorrhage group(11.7%)and 2 cases in the control group(3.3%).Fisher's exact test results in the chi-square test showed no statistical significance.In this study,there were 7 cases(11.7%)of hyperlipidemia in the microhemorrhage group and 11 cases(18.3%)in the control group.The results of Pearson chi-square test showed no difference.In this study,30 cases(50.0%)of smokers were in the microhemorrhage group and 32 cases(53.3%)were in the control group.Pearson chi-square test results showed no statistical significance.In this study,31 cases(51.7%)with hyperhomocysteinemia in the microhemorrhage group and 17 cases(28.3%)in the control group were treated with rank sum test,mann-whitney U test and logistic regression analysis showed statistical difference(P < 0.05).Therefore,it was considered that there were statistical differences between the microhemorrhage group and the control group in hypertension and high HCY,which were risk factors for CMBs.There was no significant difference in diabetes,coronary heart disease,smoking and hyperlipidemia between the two groups.P < 0.05).(see tables 1 and 2)2.In the comparison of MMSE score and MoCA score between the two groups,we used the mann-whitney U test,and the results showed that both scores in the CMBs group were lower than those in the control group,and there were statistically significant differences in cognitive scores between the two groups.(see table 3)3.The differences in MMSE and MoCa scores between patients with different levels of microhemorrhage were analyzed,and the results of kruskal-wallis test showed that there was no difference in cognitive level among the three grades of severe microhemorrhage: grade 1,grade 2 and grade 3.(see table 4)4.Among the 60 patients in the CMBs group,16 patients had lesion located in the cerebral lobe,42 patients had lesion located deep,and 23 patients had lesion located under the curtain.Conclusion:The incidence of CMBs increased in patients with hypertension and hyperhomocysteinemia.There is an increased risk of cognitive decline in patients with CMBs,which is independent of the number of CMBs.