Analysis Of Risk Factors And Imaging Characteristics About Patients With Cognitive Impairment Of Lacunar Infarction And White Matter Lesions

Objectives To observe the risk factors and imaging features about patients with cognitive impairment(CI)of Lacunar Infarction(LI)and White Matter Lesions(WML),and explore their relationship with cognitive domain impairment.Methods Patients with clinical and radiologically-recognized LI and WML who were treated in the Department of Neurology in our hospital from December 2017 to December 2018 were selected.The Montreal Cognitive Assessment(Mo CA)was used to evaluate the patients' cognitive function.134 patients with LI and CI were selected as the Lacunar Infarction Cognitive Impairment(LICI)group,and 110 patients without CI were selected as Control(LINCI)group;85 patients with WML and CI were selected as the White Matter Lesions Cognitive Impairment(WMLCI)group,and 60 patients without CI as the Control(WMLNCI)group.The risk factors of CI group and NCI group were compared;The number of LI lesions(single focus subgroup,multiple focus subgroup)and location(frontal lobe,temporal lobe,parietooccipital lobe,thalamus,infratentorial,basal ganglia subgroup)were recorded according to brain MRI results.The severity of WML(fazekas1,fazekas2,fazekas2 subgroup)was recorded by Fazekas scale.The imaging characteristics of LI and WML patients and their relationship with cognitive impairment were analyzed.Results 1 The education years and TB level of the LICI group were lower than those of the LICI group,the proportion of hypertension and hyperlipidemia was higher than that of the LICI group,and the levels of TC,Lp(a),HCY,UA,FIB and D-D were higher than those of the LICI group(P<0.05);Multivariate logistic regression showed that LICI was associated with hypertension,hyperlipidemia,and elevated serum Lp(a),HCY,FIB,and D-D levels.And combined with hypertension,hyperlipidemia,elevated D-D levels were most closely related to LICI(P<0.01).2 The detection rate of multiple lesions,left cerebral hemisphere and basal ganglia in the LICI group was high,and the difference was statistically significant compared with the LINCI group(P<0.05).3 The scores of Mo CA,visual spatial performance,delayed memory,and orientation in the multiple lesion subgroup of the LICI group were significantly lower than those in the single lesion subgroup,and the differences were statistically significant(P<0.05);In the LICI group,the focus of frontal lobe involved the executive power and attention of visual space,the focus of basal ganglia involved the executive power,attention and delayed recollection of visual space,while the focus of collicular encephalopathy mainly involved the executive power and delayed recollection of visual space,and the focus under the curtain mostly involved the attention and delayed recollection,which was statistically significant compared with other parts(P<0.05).4 The education level and TB level of WMLCI group were lower than that of WMLNCI group,the age was higher than that of WMLNCI group,the proportion of hypertension and diabetes was higher than that of WMLNCI group,the level of serum HCY,UA,FIB,Hb A1 c and D-D was higher than that of WMLNCI group,the difference was statistically significant(P<0.05);Multivariate logistic regression showed that WMLCI was mainly associated with hypertension,diabetes,elevated serum UA,Hb A1 c,and D-D levels,and decreased TB levels,and hypertension,diabetes and WMLCI were most closely related(P<0.01).5 The proportion of Fazekas Grade 3 lesions in WMLCI group was higher than that in WMLNCI group,and the difference was statistically significant(P<0.01).6 Compared with the Fazekas Grade 1 lesion subgroup,the scores of the Fazekas Grade 2 and Fazekas Grade 3 lesion subgroups were lower in terms of Mo CA total score,attention,and delayed recall(P<0.05);Fazekas grade 3 lesion sub-group scores were low in visual space execution and language ability,and the difference was statistically significant(P<0.05).Conclusions 1 Hypertension,hyperlipidemia,high levels of serum Lp(a),HCY,FIB and D-D are risk factors for LICI.Multiple,left cerebral hemisphere,and basal ganglia lesions are more likely to cause LICI,which mainly impairs visual spatial execution,delayed memory and attention.2 Hypertension,diabetes,elevated serum UA,Hb A1 c,D-D levels,and reduced TB levels are risk factors for WMLCI.The occurrence of WMLCI is related to the Fazekas grade of the lesion.The higher the Fazekas grade,the greater the degree of cognitive impairment,which mainly impairs visual space execution,attention,language,and delayed recall ability.Figure3;Table14;Reference 164...