Lacunar Cerebral Infarction Patients With Vascular Clearance Around The Related Factors Of The Research

Background and objective:Perivascular space is a potential space found between cerebral vessels and the surrounding pia mater,which is reported to be related to the disturbance of cerebral lymphatic clearance system and is closely related to the occurrence and development of a variety of nervous system diseases.Few studies have reported the risk factors of perivascular space in patients with lacunar stroke,and there is little evidence about the relationship between perivascular space and other markers of cerebellar small vessels.And the mechanism of perivascular space in different regions may not be the same.The purpose of this study is to investigate the correlation between the perivascular space severity and risk factors such as age,sex,hyperlipidemia and other imaging markers in patients with lacunar infarction.Methods:A total of 198 patients with acute lacunar infarction in Xianyang Hospital of Yan’an University were enrolled in this study.The lacunar stroke was confirmed by MRI.The clinical data and brain MRI images of the patients were collected.The perivascular spaces in the basal ganglia and the central semioval area were classified into two groups.The statistical differences of sex,age,hypertension,diabetic hyperlipidemia,high signal intensity of white matter and brain atrophy were compared among different groups of PVS.Univariate analysis and binary.Logistic regression analysis were used for analysis the risk factors of perivascular space severity in patients with lacunar infarction.Results:198 patients with lacunar stroke were enrolled in this research,with an average age of 65 ±10.2 years.The enlarged perivascular space in the basal ganglia and the central semioval area was widespread(100%).The PVS score of the basal ganglia was mild to moderate dilatation(1-2)in 131(66.1%),severe dilatation(3-4)in 67(33.9%),mild dilatation(1-2)in 167(84.4%),and severe dilatation(3-4)31(15.6%).In the basal ganglia,age(P <0.001),high signal intensity of white matter(P < 0.001)and brain atrophy(P <0.001)in severe PVS group were higher than those in mild to moderate group,triglyceride level(P < 0.003)and hyperlipidemia(0.023)were lower than those in mild to moderate group,while age(P < 0.001),white matter hypersignal(0.011),gray matter volume(0.045)and brain atrophy(P < 0.001)in semioval central area of severe PVS group were higher than those in mild and moderate group.The level of triglyceride(OR 0.009)and hyperlipidemia(0.047)were lower than those in the mild to moderate group.Multivariate logical regression analysis showed that age(OR 1.117,95% CI 1.65-1.172,P <0.001),high signal in white matter(OR 2.262,95%CI 1.318-3.884),hyperlipidemia(OR 0.341,95% CIRG 0.146-0.792,0.012)were associated with the severity of PVS in the basal ganglia.Conclusion:1.Age,High white matter and brain atrophy are the independent risk factors of perivascular space in basal ganglia area,while hyperlipidemia is the protective factor of perivascular space in basal ganglia area.2.Age is an independent risk factor of perivascular space in white matter area.