Analysis Of Risk Factors Associated With Cerebral Microbleeds In Acute Stroke Patients With Large Artery Atherosclerosis

Objective:This study aims to investigate the epidemiological and MR imaging characteristics of cerebral microbleeds(CMBs)in patients with acute large artery atherosclerotic stroke(LAAS).The risk factors of CMBs in LAAS patients were analyzed in order to provide direction for the development of individualized clinical treatment.Methods:A total of 178 first-time LAAS patients admitted to the Department of Neurology,Jincheng University Hospital Affiliated to Shanxi Medical University from January 2021to December 2022 were collected.General clinical data and laboratory parameters of enrolled patients were collected,including gender,age,body mass index,smoking history,alcohol consumption history,hypertension history,diabetes history,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,homocysteine,blood urea nitrogen,creatinine,uric acid,activated partial thromboplastin time,fibrinogen.Moreover,susceptibility-weighted imaging(SWI)images were used to calculate the number and location of CMBs in patients.According to the presence or absence of CMBs,they were divided into two groups:CMBs group and no CMBs group;according to the number of CMBs,they were divided into no CMBs group,mild group(1),moderate group(2-4)and severe group(≥5);according to the distribution location,they were divided into lobular group,deep group,subtentorial group and mixed group.SPSS26.0 was used for data analysis.The Chi-square test,two-independent sample t test or nonparametric rank sum test were used for univariate analysis.The binary logistic regression analysis was used for multivariate analysis,and Spearman rank correlation analysis was performed for independent risk factors.Results:In univariate analysis,age(t=-3.335,P=0.001),body mass index(t=1.991,P=0.048),history of hypertension(χ~2=7.085,P=0.008),low density lipoprotein cholesterol(t=2.664,P=0.008)and homocysteine(Z=2.372,P=0.018)were statistically significant.Multivariate analysis by binary Logistic regression showed age(OR=1.052,95%CI:1.013-1.092,P=0.008)and history of hypertension(OR=2.490,95%CI:1.178-5.261,P=0.017),low levels of low density lipoprotein cholesterol(OR=0.563,95%CI:0.355-0.893,P=0.015),homocysteine(OR=1.021,95%CI:1.001-1.042,P=0.044)was an independent risk factor for CMBs in LAAS patients.Spearman rank correlation analysis was conducted on age,low density lipoprotein cholesterol,homocysteine and the severity of CMBs,respectively.It was found that age(r=0.222,P=0.045)was positively correlated with the severity of CMBs in LAAS patients with CMBs,and low density lipoprotein cholesterol(r=-0.280,P=0.014)was negatively correlated with the severity of CMBs.Conclusion:1.The detection rate of CMBs in first-time LAAS patients was 46.07%,and the most common distribution location of CMBs was mixed type.2.Low body mass index is a risk factor for CMBs in LAAS patients,but it is not an independent risk factor.3.Age,hypertension,low levels of low density lipoprotein cholesterol and homocysteine were independent risk factors for CMBs in LAAS patients.4.In patients with LAAS combined with CMBs,age was positively correlated with the severity of CMBs,while low density lipoprotein cholesterol was negatively correlated with the severity of CMBs.