RESUMEN
Objective To investigate the correlation between plasma homocysteine (Hcy) level and cerebral microbleeds (CMBs) band leukoaraiosis (LA) in patients with acute stroke.Methods The clinical and imaging data of patients with acute stroke were analyzed retrospectively.The numbers of CMBs were counted and the severity of LA was graded according to the results of MRI.Fasting venous samples were obtained and the plasma Hey concentration was measured the next day after admission.Results A total of 139 patients with acute stroke were enrolled,67 of them were females and 72 were males (mean age 70.1 ± 10.2 years); 24 had hemorrhagic stroke and 115 had ischemic stroke.The age (76.23 ± 8.74 years vs.64.58 ± 7.42 years;t =4.621,P =0.012) hypertension ratio (89.13％ vs.67.74％ ;x2 =8.324,P =0.0 370) and plasma Hey level (14.53 ± 4.31 mmol/L vs.11.31 ±3.16 mmol/L;t =6.538,P=0.008| in a severe LA group (n=46) were significantly higher than those in a non-severe LA group (n =93).Spearman correlation analysis showed that there was significant correlation between the plasma Hcy level and the severity of LA (rs =0.365,P =0.002).Multivariate logistic regression analysis showed that the increased Hey level (odds ratio [ OR ],1.366,95％confidence interval [ CI] 1.141 - 1.526; P =0.010) and age (OR 1.093,95％ CI 1.031 - 1.162; P =0.016)were the independent risk factors for severe LA.The age (74.37 ± 6.35 years vs.67.56 ± 8.52 years; t =6.628,P =0.038) and hypertension ratio (94.74％ vs.62.20％;x2 =8.773,P =0.002) in a CBM group were significantly higher than those in a non-CMB group (n =82).Spearman correlation analysis showed that there was no significant correlation between the plasma Hcy level and the numbers of CBMs (rs =0.038,P =0.813).Multivariate logistic regression analysis showed that hypertension was an independent risk factor for CBMs.Conclusions The elevated plasma Hcy level was associated with LA,but it was not associated with CBMs.
RESUMEN
Objective To investigate the risk factors for leukoaraiosis (LA). Methods The clinical and imaging data in patients with stroke were collected retrospectively. LA was divided into periventricular LA and subcortical LA according to the findings of MRI, and they were scored and classified. Results A total of 113 patients with stroke were included. There were 39 women and 74 men (mean age 61.33 ± 1.32 years). The age (65.52 ± 12. 56 vs.47. 96 ±9. 23 years, t =5. 634, P =0. 000), hypertension (68. 60% vs. 29. 63% ,x2 = 12. 932,P =0. 000), diabetes (30. 23% vs. 3.70%, x2 = 7. 953, P = 0. 005), systolic blood pressure (SBP) (147. 42 ± 2. 78 mm Hg vs. 134. 00 ± 22. 45 mm Hg,t = 2. 862, P = 0. 004), glucose (6. 54 ± 3. 48 mmol/L vs. 5. 35 ± 1.37 mmol/L, t = 2. 808, P = 0. 005), and total cholesterol (TC) level (5. 17±0.89 mmol/L vs. 4.59±0.61 mmol/L, t=3. 152, P=0. 002) in patients with periventricular LA (n = 86) were significantly higher than those without periventricular LA (n =27). The age (66. 44 ± 11.33 vs. 47. 96 ±9. 23 years, t =4. 768, P =0. 000), hypertension (74. 29% vs. 34. 88%, x2 = 17. 134, P = 0. 000), SBP (85.46 ± 9. 80 mm Hg vs. 69. 81 ±8. 74 mm Hg, t =2. 999, P=0. 003), diastolic blood pressure (DBP) (85.46 ±9. 80 mm Hg vs.69. 81 ±8.74 mm Hg, t =2. 999, P =0. 003), and TC level (5.22±0.99 mmol/L vs. 4.91 ±0. 75 mmol/L, t =3. 330, P =0. 001) in patients with subcortical LA (n =70) were significantly higher than those without subcortical LA (n =43). Spearman correlation analysis showed that the periventricular LA classification was significantly correlated with the age (rs = 0. 606, P =0. 000), drinking (rs = -0. 257, P = 0. 006), hypertension (rs = 0. 428, P = 0. 000), diabetes (rs =0. 236, P =0. 012), SBP (rs =0. 382, P =0. 000), and DBP (rs =0. 258, P =0. 006). The subcortical LA classification was significantly correlated with the age (rs = 0.488, P = 0. 000),hypertension (rs = 0. 416, P = 0. 000), SBP (rs = 0. 386, P = 0. 000), DBP (rs = 0. 326, P =0. 006), and TC level (rs =0. 231, P =0. 014). Multivariate logistic regression analysis showed that the age (odds ratio[OR] = 1.071, 95% confidence interval [CI] 1.009-1. 137; P=O. 024), hypertension (OR =4. 106, 95% CI 1. 657-10. 174; P =0. 002), and SBP (OR =1. 049,95% CI 1. 162-7. 013; P = 0. 022) were independently correlated with LA. Conclusions The age, hypertension, and SBP are the independent risk factors for LA, in which the age is an uncontrollable factor, and the aggressive prevention and treatment of hypertension may reduce the occurrence of LA.