Clinical Analysis Of Risk Factors Associated With Cerebral Microbleeds In Patients With Acute Cerebral Infarction

Objective:This study was aimed to explore the correlation between cerebral microbleeds(CMBs)and Cystatin C(CysC),C-reactive protein(CRP)in patients with acute cerebral infarction(ACI),and analyze the related risk factors of ACI complicated with CMBs as well,to provide theoretical basis and clinical evidence for secondary prevention and treatment of stroke complicated with CMBs.Methods:A total of 115 patients diagnosed with ACI who were hospitalized in the Department of Neurology of the Second Hospital of Jilin University and completed the Susceptibility Weighted Imaging inspection from December 2016 to December 2019 were enrolled in this study.The number and distribution of CMBs were recorded,as well as other clinical data including the patients' age,gender,body mass index(BMI),hypertension,diabetes,atrial fibrillation,stroke history,smoking and drinking,whether used the antithrombotic drugs,CysC,hypersensitive c-reactive protein(Hs-CRP),creatinine,fasting blood-glucose,uric acid,total cholesterol,triglyceride,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),lipoprotein a,homocysteine(Hcy),activated partial thromboplastin time(APTT),white matter hyperintensities(WMH)and so on.The patients were divided into CMBs-positive group and the negative one,and the relevant data were statistically analyzed;The patients with CMBs-positive were stratified into mild,moderate and severe groups according to the number of CMBs,and the relevant data were statistically analyzed.According to the different distribution of CMBs,the patients were furtherly divided into strictly lobar group,deep group,subtentorial group and mixed group,and the data were statistically compared between groups.All statistics were analyzed by the SPSS 26.0 software.Result:1.Through the SWI inspection,67 cases were found to have CMBs positive among the 115 ACI patients,which accounted for 58.3%.Most of the CMBs positive were in the mixed group,which accounted for 58.2%.2.In the comparison of clinical data between the positive group and the negative group,the differences in age,hypertension,CysC,triglyceride and WMH are statistically significant(P<0.05).The other factors such as gender,BMI etc have no significant difference between the two groups(P>0.05).Multivariate Logistic regression analysis find that hypertension,severe WMH and drinking history are independent risk factors for CMBs in patients with ACI.3.In the comparison of clinical data among the mild,moderate and severe groups,the differences in LDL-C,total cholesterol,fasting blood-glucose,WMH,hypertension and atrial fibrillation history are statistically significant(P<0.05).The other factors such as age,gender,BMI etc have no significant difference among the three groups(P>0.05).The level of LDL-C in the severe group is lower than that in the mild and moderate group in the further pairwise comparison(P<0.05);the level of total cholesterol in the severe group is lower than that in the moderate group(P<0.05);the WMH scores in the severe group are significantly higher than that in the mild group(P<0.01);and the patients in the severe group with hypertension are more than that in the moderate group(P<0.05).Multivariate Logistic regression analysis demonstrate that hypertension and severe WMH are independent risk factors for the severity of CMBs with ACI.4.In the comparison of clinical data among the lobar,deep,subtentorial and mixed group,the differences in smoking history,WMH scores and triglyceride are statistically significant(P<0.05).There are no statistically significant differences among the four groups in other variables(P>0.05).The WMH scores of the mixed group are higher than that of the deep group,the level of triglyceride in the subtentorial group is higher than that of the deep group,and the amount of smoking patients in the subtentorial group is larger than that in the mixed group in the further pairwise comparison(P<0.05).5.There is a moderate positive correlation between CysC and Hcy in the ACI patients with CMBs(P<0.01)and a weak positive correlation between CysC and uric acid(P<0.01).There is a strong positive correlation between the amount of CMBs and WMH scores(P<0.01).Conclusions:1.Age is a risk factor for CMBs in ACI patients,but not an independent risk factor.2.Hypertension and drinking history are independent risk factors for CMBs in ACI patients,while hypertension is also an independent risk factor for the severity of CMBs in ACI patients.3.CysC is a risk factor for CMBs in ACI patients,but it's not an independent risk factor,and there is no relationship between the level of CysC and the number,distribution of CMBs.There is also no significant correlation between the level of Hs-CRP and the presence,severity and location of CMBs in ACI patients.Triglyceride and a certain level of LDL-C may be protective factors for CMBs in ACI patients.Severe WMH is an independent risk factor for the presence and severity of CMBs in ACI patients.