| Background and Purpose:The etiology and pathogenesis of cerebral small vess el disease and its subtypes are not yet entirely clear.So the relationship betwe en macroangiopathy and cerebral small vascular diseases needs to be clarified f urther.This study used magnetic resonance imaging and Doppler ultrasound to identify the large and small arterial vascular lesions in patients with ischemic c erebrovascular disease to investigate the relationship between atherosclerosis and cerebral small vessel disease,and to analyze the risk factors of this disease a nd its clinical prognosis,which suggested the correlation and difference betwee n the two risk factors.Methods:The retrospective study method was used by the ischemic stroke patie nts hospitalized in the Department of Neurology,Qianfoshan Hospital,Shandon g Province from February 2015 to June 2018.According to imaging examinati on,clinical manifestations and diagnostic criteria,the subjects were divided into two groups:one group with non-SVD patients and another group with SVD p atients.All patients were evaluated for intracranial stenosis,carotid stenosis,etc.And all patients were investigated for high risk factors such as high triglyceri de(TG),high total cholesterol(TC),high Hcy concentration,alcohol consumpti on,diabetes,high blood pressure,gender,age and the increase of low density lipoprotein cholesterin(LDL-C).Patients with stroke were followed up and wer e used the Barthel Index(BI)Scale and the Modified Rankin Scale(MRS)to score them.The characteristics and risk factors of aortic lesion in the two gro ups were studied and analyzed.At the same time,the relationship between co mmon subtypes of cerebral small vessel disease and aortic lesion was studied a nd analyzed.Results:A total of 243 patients with ischemic stroke were enrolled into the stu dy,including 109 patients in the SVD group and 124 patients in the non-SVD group.The average age of patients is(64.24±10.53).In this study,it found that there were four SVD independent risk factors:the first factor was high total cholesterol(TC)(95%CI:1.04?2.20,OR=1.53),the second factor w as high blood pressure(95%Cl:1.23 to 2.67,OR=1.80),the third factor w as male(95%CI:1.43 to 3.16,OR=2.20),and the last factor was age(95%CI:1.10 to 2.47,OR=1.67).And it also found that compared with non-SVD patients,there were four WML independent risk factors:the first factor was diabetes(95%CI:0.69?2.47,OR=1.57),the second factor was hypert ension(95%Cl:1.24 to 2.68,OR=1.79),the third factor was male(95%CI:1.42 to 3.14,OR=2.17),and the last factor was age(95%Cl:1.11 to 2.48,OR=1.59).Still,it found that compared with non-SVD patients,there were four independent risk factors for LI:the first factor was high total cholesterol(TC)(95%CI:0.37?1.89,OR=0.94),the second factor was Hypertension(95%CI:1.48-2.95,OR=1.92),the third factor was male(95%Cl:1.39 to 3.07,OR=2.21),and the last factor was age(95%Cl:1.10 to 2.59,OR=1.61).Among the 243 selected patients,25 patients were carotid stenosis,10.3%of the total,of which 3 patients were occlusion and 3 patients were severe st enosis,which both occupied 1.2%of them.There were 9 patients with moder ate stenosis and 19 patients had mild stenosis,which separately occupied 3.7%and 7.8%of patients.176 patients existed Carotid atherosclerosis,accounte d for 72.4%of patients,of which 110 patients were multiple plaques,which o ccupied 45.3%of them.And there were 94 patients were vulnerable plaques,139 patients were plaques,which seperately occupied 38.7%and 57.2%of the t otal.The mean carotid-media thickness(IMT)was(1.03±0.16)mm and the average plaque area(TPA)was(32.64±52.21)mm2.Among the patients wit h intracranial artery stenosis(any degree),39(16.5%)were detected,including 27 cases(11.1%)with mild stenosis,10 cases(4.1%)with severe stenosis,an d 2 cases(0.8%)with occlusion.After adjusting the age and gender of the SV D and non-SVD groups,the Logistic regression analysis showed that there wer e four factors that were significantly associated with SVD.The first one was v ulnerable plaque(95%Cl:1.08 to 2.35,OR=1.58),the second factor is IMT t hickening(95%CI:1.19?2.75,OR=1.81),the third factor is carotid stenos is(95%CI:1.51?6.39,OR=3.23),and the fourth factor is intracranial arte ry stenosis(95%CI:1.23 to 6.12,OR=2.97).Compared with WML patient s,LI patients had significant differences in three factors(P<0.05).The first on e was vulnerable plaque(95%CI:1.24?2.39,OR=1.61),the second one was C arotid stenosis(95%CI:1.58 to 5.27,OR=2.93),and the third factor was in tracranial artery stenosis(95%CI:1.84 to 7.12,OR=4.73).In terms of prog nosis,patients with SVD were lower than non-SVD patients in the aspect ofall-cause mortality and MRS scores.And the BI scores were higher than non-SV D patients,P<0.05,which had significant differences.However,the proportio n of stroke recurrence in these two groups P>0.05,had no significant differenc e.Conclusion:There are significant differences in risk factors between SVD and n on-SVD.Risk factors for LI,WML and non-SVD are also different.SVD is a ssociated with aortic vascular disease.LI is closely related to carotid stenosis a nd vulnerable plaque.WML is closely related to intracranial stenosis.Although SVD has a better prognosis than non-SVD in the short term,prognosis is po or in the long-term.By revealing the common subtypes and risk factors of SV D,it's helpful to treat and prevent SVD clinically,thus it can provide referenc es for medical personnel to take relevant measures. |
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