Risk Factors Of Cerebral Microbleeds In Patients With Acute Ischemic Stroke

Objective:The objective of this study is not only to investigate the incidence and location of cerebral microbleeds in patients with acute ischemic stroke but also to analyze and evaluate the correlation between demographic and clinical factors as well as the occurrence,number and distribution of CMBs in AIS patients,so as to provide guidance for the treatment and long-term prognosis of AIS patients.Methods:We evaluated consecutive patients with AIS who were admitted to the First Hospital of Jilin University from April 2019 to September 2020.The general data and laboratory examination of the patients were collected.For each subject the number and localization of the microbleeds was recorded.555 subjects were divided into without-CMBs and CMBs by the occurrence of CMBs.Based on the number of CMBs,we classified the degree as absent,mild(total number of CBMs,1 to 4),moderate(5 through 9),and severe(≥10).CMBs were categorized into 4 groups: lobar,deep,infratentorial and mixed,according to their locations.To analyze the differences of demographic and clinical factors in patients with acute ischemic stroke among different groups.Results:The study population consisted of 555 patients with AIS,including 334(60.18%)patients in the CMBs group(250(74.85%)males and 84(25.15%)females).They were divided into without-CMBs group(39.82%),mild group(35.14%),moderate group(13.15%)and moderate group(11.89%).CMBs were most prevalent in the mixed region(60.18%),followed by deep(20.66%),lobar(9.58%)and infratentorial regions(9.58%).In the comparison between without-CMBs and CMBs group,there were differences in age,gender,history of hypertension,history of stroke,history of use of antiplatelet drugs,and levels of systolic blood pressure,diastolic blood pressure,uric acid and creatinine after admission(P<0.05).Multivariate analysis revealed that age,history of stroke,history of hypertension,systolic blood pressure,serum creatinine level were independently correlated with the occurrence of CMBs in patients with AIS.In univariate analysis manifested statistically significant differences in age,history of hypertension,history of diabetes,history of stroke,history of antiplatelet drug use,systolic blood pressure,diastolic blood pressure,homocysteine,and creatinine in different severity grades(P<0.05).The results of logistic regression analysis displayed that older age,history of stroke,history of diabetes,history of hypertension,elevated systolic blood pressure level,and elevated creatinine level were independently associated with the severity of CMBs.In contrast,diabetes history was an independent protective factor for the severity of CMBs.Among CMBs with different distribution types,univariate analysis showed statistically significant differences in the history of stroke and the history of antiplatelet drug use(P<0.05).Conclusion:1.Age,history of hypertension,history of stroke,elevated systolic blood pressure as well as elevated creatinine level were independent risk factors for CMBs in patients with AIS.2.Age,history of stroke,history of hypertension,diabetes,elevated systolic blood pressure and elevated creatinine level can independently increase the severity of CMBs in patients with AIS,and the severity of CMBs in patients with AIS with a history of diabetes is lower than that in patients without a history of diabetes.3.There was a difference in stroke history as well as antiplatelet drug use history among different distribution types of CMBs patients.