Comparative Study On Risk Factors Of Massive Cerebral Infarction And Massive Cerebral Hemorrhage

Objective:To explore and compare the risk factors of massive cerebral infarction and massive cerebral hemorrhage,and find out their common and different risk factors.Methods:A total of 400 patients(the patients number of large cerebral infarction,non-large cerebral infarction and large cerebral hemorrhage,non-large cerebral hemorrhage are all 100)hospitalized in Neurology Department and Cerebral Stroke Center of the First Affiliated Hospital of NanChang from September 2016 to September 2019 were selected randomly.The grouping criterion of massive cerebral infarction group is based on the diagnostic criteria for massive cerebral infarction in Adama classification method:the diameter of the infarction lesion is above or equal to 3 cm,and the diagnostic criteria for more than two anatomical parts were accumulated.Patients who met the above criteria were put into the massive cerebral infarction group(the cerebral infarction observation group),while those who do not met one of the criteria were put into the non-massive cerebral infarction group(the cerebral infarction control group);The long diameter and wide diameter of the largest layer of the lesion in the hematoma layer,the number of hematoma layers and the thickness of each layer of patients with cerebral hemorrhage were collected,and the hematoma volume was finally calculated as V=1/2 x long diameter x wide diameter x number of layers x thickness of each layer with the Coniglobus formula.The grouping criterion of massive cerebral hemorrhage group(cerebral hemorrhage observation group)is the hematoma volume above or equal to 30 ml,and the grouping criterion of non-massive cerebral hemorrhage group(cerebral hemorrhage control group)is the hematoma volume below 30 ml.Data collection:general information,laboratory test data and imaging data were mainly collected.General information mainly included some contents of the patients'relevant medical history,including the patients'age,gender,presence or absence of hyperten-sion,diabetes,atrial fibrillation and other medical history,as well as information such as smoking history,alcohol abuse history,personal history,family history,other past medical history and physical examination.Laboratory test data were collected as follows:neutrophil value,lymphocyte value,blood glucose,blood type,homocysteine(Hcy),D-Dimmer(DD),Lipoprotein(a)(Lp(a)),and screening results of antinuclear antibodies(ANA),Systolic blood pressure(SBP),Diastolic blood pressure(DBP),triglycerides(TG),Total cholesterol(TC),specific protein of nervus centralis(S100-?protein)and other indicators.Neutrophil lymphocyte ratio(NLR)of patients could be obtained by dividing the number of neutrophils as the numerator and the number of lymphocytes as the denominator,which was also an important indicator in this study.Imaging indicators:The imaging results such as head CT and head MRI of patients within 24 hours after being hospitalized were mainly collected,and then assess whether the inclusion criteria are met and which group should be included.After the above data were collected,the cerebral infarction observation group and the cerebral infarction control group were integrated into the group of cerebral infarction while the cerebral hemorrhage observation group and the cerebral hemorrhage control group were integrated into the group of cerebral hemorrhage.And then,relevant information and data of the cerebral infarction observation group and the cerebral infarction control group were compared,and the same steps were conducted for the cerebral hemorrhage observation group and the cerebral hemorrhage control group.The above general information and laboratory test data were mainly compared.Single-factor analysis was conducted by SPSS software.The above factors with statistical differences(P<0.05)and no significant data missing were collected.Then the above data were subjected to dichotomy logistic analysis,and the independent correlation factors of them were obtained.Finally,they were compared,and the similarities and differences of independent or non-independent risk factors were found.Results:1.Non-massive cerebral infarction group and massive cerebral infarction group were found to have significant differences(P<0.05)in NLR(Z=-6.978,P=0.000),DD(Z=-6.116,P=0.000),blood glucose(Z=-2.029,P=0.042),Hcy(Z=-5.328,P=0.000),Lp(a)(Z=-5.135,P=0.000),TG(Z=-2.929,P=0.003)and atrial fibrillation history(X~2=6.105,P=0.013).Among them,only TG level in massive cerebral infarction group was significantly lower than that in non-massive cerebral infarction group.After multi-factor logistic regression analysis of the above indicators with statistical differences and no obvious data missing,the significant indicators were NLR(OR=1.270,95%CI=1.126-1.434),Hcy(OR=1.069,95%CI=1.016-1.124),Lp(a)(OR=1.003,95%CI=1.001-1.005),and the study subjects with higher NLR,Hcy and Lp(a)were more likely to suffer from massive cerebral infarction.2.The age(t=-3.052,P=0.003),NLR(Z=-5.955,P=0.000),DD(Z=-4.562,P=0.000),blood glucose(Z=-6.166,P=0.000),SBP(Z=-3.128,P=0.002),hypertension history(X~2=6.047,P=0.014)of non-massive cerebral hemorrhage group and massive cerebral hemorrhage group were significantly different(P<0.05).After multi-factor logistic regression analysis of the above indicators with statistical differences and no obvious data missing,the significant indicators were age(OR=1.034,95%CI=1.006-1.064),NLR(OR=1.179,95%CI=1.091-1.275)and blood glucose(OR=1.581,95%CI=1.262-1.980),and the study subjects with higher age,NLR and blood glucose were more likely to suffer from massive cerebral hemorrhage.Conclusions:1.The risk factors of massive cerebral infarction are NLR,DD,blood glucose,Hcy,Lp(a),and atrial fibrillation history.Among them,NLR,Hcy,Lp(a)are independent risk factors for massive cerebral infarction.2.The risk factors of massive cerebral hemorrhage are:age,NLR,DD,blood glucose,SBP,and hypertension history.Among them,age,NLR and blood glucose are independent risk factors for massive cerebral hemorrhage.3.Compared with the risk factors and independent risk factors for massive cerebral infarction and massive cerebral hemorrhage,we found that the common risk factors of the two diseases are NLR,DD and blood glucose,but only NLR is the common independent risk factor of the two diseases.