Study On The Correlation Between Patent Foramen Ovale And White Matter Lesions In Young And Middle-aged People

Objective: To explore the relationship between white matter lesions and patent foramen ovale in young and middle-aged people and the influence of other cerebrovascular disease risk factors on white matter lesions.Methods: According to the inclusion and exclusion criteria,a total of 219 inpatients with cerebral infarction or transient ischemic attack(TIA)diagnosed in the Department of Neurology,Affiliated Hospital of Yanbian University from January2019 to December 2020 were included,including 149 males and 70 females.The basic data of the patients were collected.All patients completed MRI and c-TCD examination.The degree of periventricular white matter lesions(pwml)and deep white matter lesions(DWML)were evaluated according to Fazekas visual scoring method.The right to left shunt(RLS)was evaluated by five level classification system.The information of all patients was summarized and entered into Excel software,Import spss24.0 software to establish database and analyze.Quantitative variables are described using mean values ± In this study,the dependent variables were ordinal variables.Krusk Wallis h nonparametric test was used for univariate analysis.Significant factors were included in the multivariate ordinal logistic regression model for analysis.Results:(1)A total of 219 patients were investigated in this study,including 149males(68.0%)and 70 females(32.0%),among which 73 patients(33.3%)had no WMLs,113 patients(51.6%)had mild WMLs,and 33 patients(15.1%)had moderate and severe WMLs.(2)In univariate analysis,there were significant differences in age,gender,drinking,hypertension,diabetes and homocysteine(P < 0.1).Age and gender were used as adjustment factors,white matter lesions were used as dependent variables,and the meaningful ones in univariate test were used as independent variables to be included in the ordered multiple logistic regression model.The results showed that age,hypertension and hyperhomocysteinemia may be the influencing factors of white matter lesions.With the increase of age,the incidence of severe white matter lesions may increase by 7.0%.The or of patients with hypertension is 2.519 times that of patients without hypertension,and the or of patients with hyperhomocysteinemia is1.902 times that of normal people.Drinking alcohol may be a protective factor of white matter lesions(OR = 0.456,95%CI:0.248-0.844).(3)The foaming test was positive in 74 patients(33.8%)and negative in 145patients(66.2%).The foaming test classification of 74 positive patients was large number of patients(25 cases,11.4%),medium amount of foaming test(11 cases,5.0%),and small amount of foaming test(38 cases,17.4%).Among the 74 cases of positive foaming,35 cases were inherent type(16.0%)and 39 cases were latent type(17.8%).Correlation analysis showed that the grade of foaming test had a negative correlation with WMD(r=-0.138,P=0.041),and the correlation was weak.There was no correlation between the foaming test and white matter lesions(P > 0.05).Conclusion: There was a negative correlation between the grade of foaming test and white matter lesions,but the correlation was weak.There was no correlation between foaming test and white matter lesions.Age and hypertension are independent risk factors for white matter lesions.Hyperhomocysteinemia is related to white matter lesions.Drinking may be a protective factor for white matter lesions.