The Relationship Between Enlarged Perivascular Space And Cognitive Function In Patients With Acute Ischemic Stroke And It's Risk Factors

Part one The relationship between the enlarged perivascular space and cognitive function in patients with acute ischemic strokeObjective: To investigate the risk factors of cognitive function and the relationship between the enlarged perivascular space(EPVS)and cognitive function in patients with acute ischemic stroke(AIS).Methods: 223 patients with first-episode acute cerebral infarction admitted to the department of neurology in our hospital from September 2016 to December 2018,and completed the test of cognitive function were chosen in our study.All patients were divided into cognitive impairment group and normal cognitive group according to the Mo CA score.The general,blood and imaging data of all subjects were collected and arranged.Then,t-test,Chi-square test and logistic regression analysis and so on were used to analyze the risk factors of cognitive function and the relationship between EPVS and cognitive function.Results:1.Age,history of coronary heart disease,Hcy,Fib,BG-EPVS and CSO-EPVS of the two groups were statistically significant(P<0.05).The age,Hcy and Fib levels and the proportion of moderate-severe degree of BG-EPVS and CSO-EPVS of the cognitive impairment group were higher than those of the cognitive normal group.2.Variables with P<0.1 in univariate analysis,such as age,history of coronary heart disease,drinking history,Hcy,Fib,BG-EPVS and CSO-EPVS,were analyzed by stepwise entry method of the binary multivariate logistic regression model.The results showed that age(OR=1.070,95%CI: 1.035-1.106,P<0.05),Hcy(OR=1.033,95%CI:1.007-1.160,P=0.013),and BG-EPVS(OR = 2.055,95%CI: 1.041-4.055,P= 0.038)may be independent risk factors for cognitive impairment.3.The degree of BG-EPVS in the cognitive impairment group was negatively correlated with the total Mo CA score,visual space and execution,attention,language and orientation,among which the total Mo CA score(r=-0.332,P< 0.05)and orientation(r=-0.370,P< 0.05)were stronger.Part two Risk factors for enlarged perivascular space in patients with acute ischemic strokeObjective: To explore the risk factors of EPVS in patients with AIS.Methods:208 patients with glomerular filtration rate(GFR)were selected from the first part and were divided into two groups: BG-EPVS and CSO-EPVS.According to the classification of EPVS,the subjects were divided into two groups: mild group(0-1 grade)and moderate-severe group(2-4 grade),the general,blood and imaging data were collected and sorted out,and the data were further analyzed by t-test,Chi-square test,multiple logistic regression analysis and other statistical methods to analyze the risk factors of EPVS in different sites.Results:1.In the BG-EPVS,there were statistically significant differences in age,GFR,PVH,DWMH and LI between the two groups(P< 0.05).The age,grade degree of PVH,DWMH and LI in the moderate-severe group were higher than that in the mild group,while the GFR was lower.In the CSO-EPVS,the two groups were statistically significant(P< 0.05)in GFR,PVH and DWMH.The GFR of the moderate-severe was lower than that of the mild group,while the grade degree of PVH and DWMH was higher.2.The variables with statistical significance in univariate analysis: Age,GFR,PVH,DWMH,LI and so on were substituted into binary multivariate logistic regression model by stepwise entry method.The results showed that LI(OR = 2.051,95% CI: 1.502-2.802,P< 0.01)was an independent risk factor for BG-EPVS,while DWMH(OR = 1.646,95% CI: 1.041-4.055,P= 0.008)was an independent risk factor for CSO-EPVS.3.The grade degree of BG-EPVS was positively correlated with LI(r=0.332),and the grade degree of CSO-EPVS was positively correlated with DWMH(r=0.141).Conclusions:1.Age,Hcy and BG-EPVS are independent risk factors for cognitive impairment in patients with AIS.2.There was a negative correlation between BG-EPVS and cognitive function in patients with AIS.The higher the grade of BG-EPVS,the more obvious the decline of cognitive function,mainly reflected in the overall cognitive function and orientation.3.LI may be an independent risk factor for BG-EPVS,while DWMH may be an independent risk factor for CSO-EPVS.4.The grade degree of BG-EPVS is positively correlated with LI,and the grade degree of CSO-EPVS is positively correlated with DWMH.