| Objective:To investigate the dynamic changes of cerebral microbleeds and its relationship with related risk factors in patients with acute and convalescent Cerebral Infarction before and after antiplatelet（aspirin）treatment.Method:Patients with acute cerebral infarction who were treated in the Department of Neurology of our hospital from July 2020 to January 2022 were selected for research,and a total of 99 patients who met the following conditions were included.The details are as follows: the time from the onset of the patient to the treatment is within 72 hours,the NIHSS score is between 4 points and 16 points,and the head CT and MRI examinations,including T1 WI,T2WI,FLAIR,DWI,MRA and SWI sequences,are completed during this period.According to the head SWI,they were divided into CMBs positive group（54 cases）and CMBs negative group（45 cases）.CMBs positive group was further divided into 3 groups according to the number of groups: group A（1-4）with 34 cases,group B（5-9）with 12 cases,and group C（≥10）with 8 cases.The general clinical information（age,gender,history of hypertension,history of diabetes,history of smoking,history of drinking,history of cerebral hemorrhage,history of cerebral infarction,history of taking aspirin）and test indicators（low-density lipoprotein,HDL,triglycerides,total cholesterol,glomerular filtration rate,uric acid,homocysteine）.The included patients were given aspirin（aspirin,100mg/d）,followed up 3 months later,recorded the changes in the number of intracranial CMBs in each group after follow-up,and analyzed the risk factors of cerebrovascular disease in the patients.SPSS25.0 statistical software was used for data analysis,and P<0.05 was considered statistically significant.Result:1.At the time of admission,45 patients（45.5%）in the CMBs-negative group and54（54.5%）in the CMBs-positive group,including 34 patients（34.3%）in group A（1-4）and 12 patients（12.1%）in group B（5-9）,and 8 patients（8.1%）in group C（≥10）.After 3 months of follow-up,the changes in each group were as follows: 38 cases（38.4%）in the CMBs-negative group,and 61 cases in the CMBs-positive group（61.6%）,39 patients（39.4%）in group A（1-4）,13 patients（13.1%）in group B（5-9）,and 9 patients（9.1%）in group C（≥10）.The data analysis of each group based on the statistics of admission and follow-up showed no significant difference（P>0.05）.Before antiplatelet therapy,the incidence of CMBs in AIS was 54.5%,and after 3months of antiplatelet therapy,the prevalence of CMBs in the patient population was61.6%,with no significant progression（P>0.05）.2.Analysis of risk factors:（1）Univariate analysis was performed between the CMBs-negative group and the CMBs-positive group,and there were statistically significant differences in patient age,history of hypertension,history of cerebral hemorrhage,carotid plaque,and triglyceride levels（P<0.05）.Further multivariate regression analysis showed that there were statistically significant differences in patient age and history of hypertension（P < 0.05）,which were independent risk factors for CMBs.（2）Univariate analysis of different groups of CMBs showed that there were significant differences in age and history of hypertension among the three groups（P <0.05）,which was a suspicious influencing factor leading to the increase of CMBs.The post pairwise comparison using LSD method found that under the condition of significance level of 0.05,the age of patients without CMBs was significantly lower than that of patients in group A and group B.The history of hypertension in different groups was analyzed and compared.It was found that there were differences between patients without CMBs and groups A,B and C;In the CMBs positive group,there are differences between group B,group A and group C.（3）In addition to gender and age,we further conducted quantitative statistics on each single factor included in this study,and divided them into two groups with a median of 5 as the cut-off point.It was found that the number of CMBs was significantly correlated with the increase of risk factors.（P<0.05）.Conclusion:1.Before the disease,the incidence of CMBs in AIS was about 54.5%;After 3months,the incidence of CMBs was 61.6%.The increase in CMBs was independent of the presence of CMBs at baseline.For AIS patients with CMBs,aspirin antiplatelet therapy is still safe and necessary in the short term.2.Age,history of hypertension,history of cerebral hemorrhage,carotid artery plaque and triglyceride level are risk factors for CMBs in AIS patients.Age and history of hypertension were independent risk factors for CMBs.3.Age and history of hypertension were independent risk factors for the increased number of CMBs.The number of CMBs increased with the increase of risk factors of cerebrovascular disease. |
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