Study On The Influencing Factors Of Cerebral Microbleeds In Acute Cerebral Infarction And The Distribution Of TCM Syndrome Types

Objective:The incidence rate of acute cerebral infarction is about 110/10 million,the mortality rate is about 10%,the disability rate is over 50%,and the recurrence rate of survivors is as high as 40%.With the increasing trend of population aging in China,the incidence rate of acute cerebral infarction has increased significantly.The existence of cerebral microbleeds increases the risk of intracranial hemorrhage after antithrombotic therapy.Susceptibility weighted imaging is highly sensitive to hemorrhagic lesions,Objective to find cerebral microbleeds by SWI examination,explore the correlation between cerebral infarction combined with microbleeds and TCM syndromes,guide clinical application of TCM treatment and reduce the risk of bleeding.Method:A retrospective analysis was conducted on patients with acute cerebral infarction who completed SWI examination in the Affiliated Hospital of Chengdu University of traditional Chinese medicine from May 2017 to January 2021,to observe the incidence of cerebral microbleeds in patients with acute cerebral infarction,and analyze the risk factors of cerebral microbleeds and the relationship between cerebral microbleeds and TCM syndromes in detail.Result:1.CMBS were positive in 91 of 172 patients with acute ischemic stroke,CMBS were negative in 81 cases,and the detection rate of CMBS was 52.9%.The age range of included cases was 32-92 years old,and the average age was(67.5 ± 11.501)years.There were 107 males and 65 females.The ratio of male to female was 1.65.There were 54 cases of smoking history,43 with drinking history,119 patients with hypertension,51 with diabetes mellitus,15 with history of heart disease,59 patients with history of anti thrombotic drugs,147 cases with cervical vascular plaque.There were 30 cases of acute ischemic stroke with mild cerebral microbleeds,31 cases of moderate cerebral microbleeds and 30 cases of severe cerebral microbleeds.2.Baseline data analysis:The incidence of CMBS is higher in elderly patients with acute stroke,The proportion of CMBS positive group with hypertension(P = 0.008)and history of taking antithrombotic drugs(P =0.029)was higher than that of CMBS negative group,the difference was statistically significant(P < 0.05).The level of homocysteine in CMBS positive patients was significantly higher than that in CMBS negative patients(P = 0.001).There was no significant difference in gender,smoking history,drinking history,heart disease(coronary heart disease,atrial fibrillation),cervical vascular plaque,cholesterol,triglyceride,high density lipoprotein,low density lipoprotein and uric acid between the two groups(P > 0.05).3.Correlation between acute cerebral infarction with cerebral microbleeds and TCM Syndromes:In 91 cases of CMBS positive patients,there were21 cases of wind phlegm Blocking Collaterals syndrome,13 cases of wind fire disturbance syndrome,31 cases of qi deficiency and blood stasis syndrome,10 cases of yin deficiency and wind movement syndrome,9 cases of liver and kidney deficiency syndrome,1 case of syndrome of phlegm-damp clouding and 6 cases of phlegm-heat blocking internally syndrome.Verified by chi square and exact probability method,the syndromes had nothing to do with age,gender and history of taking antithrombotic drugs,but they were related to the history of hypertension,the syndrome of phlegm-damp clouding 、 phlegm-heat blocking internally syndrome 、 yin deficiency and wind movement syndrome were only distributed in patients with hypertension,and the syndrome of wind phlegm obstructing collaterals is common.Qi deficiency and blood stasis syndrome were more common in patients without hypertension.By rank sum test,there is a correlation between syndrome type and CMBS degree,the differences in the different CMBs degrees distribution of wind fire disturbance syndrome and yin deficiency and wind movement syndrome were significant(P = 0.006).Qi deficiency and blood stasis syndrome was the most at the number of CMBS in mild,while were the least at the number of CMBS in severe.Conclusion:1.The detection rate of cerebral microbleeds in acute ischemic stroke was 52.9%,age,hypertension,homocysteine and history of taking antithrombotic drugs were correlated with the occurrence of CMBs.2.The degree of cerebral microbleeds is related to hypertension,the more severe CMBS were in patients with hypertension.3.Distribution of TCM Syndrome Types in CMBS positive group,Qi deficiency and blood stasis syndrome was the most common,followed by wind phlegm Blocking Collaterals syndrome,the syndrome of phlegm-damp clouding was the least.Hypertension and the degree of cerebral microbleeds are related to the distribution of TCM syndrome types.Age,gender and history of taking antithrombotic drugs did not affect the distribution of TCM syndrome types.