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| Analysis of independent risk factors of the severity of white matter hyperintensity and the Chinese medicine syndrome elements of related correlation with cognitive impairment |
| Hits 404 Download times 277 Received:December 10, 2023 |
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| DOI
10.11656/j.issn.1672-1519.2024.02.04 |
| Key Words
white matter hyperintensity;the independent risk factors;cognitive impairment;syndrome element;correlation |
| Author Name | Affiliation | E-mail | | ZHANG Chaonan | Department of Encephalopathy Section Three, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China | | | SONG Lianying | Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China | | | TANG Meili | Department of Encephalopathy Section Three, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China | | | FAN Ming | Department of Encephalopathy Section Three, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China | | | WANG Shuyuan | Department of Encephalopathy Section Three, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China | | | YANG Chengzhi | Department of Encephalopathy Section Three, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China | md_ycz@126.com |
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| Abstract
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| [Objective] To investigate the independent risk factors of the severity of white matter hyperintensity（WMH），the relationship between WMH and cognitive impairment and the syndrome elements characteristics of cognitive impairment patients. [Methods] The 130 WMH patients admitted to the Department of Encephalopathy of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2019 to December 2022 were selected and divided into mild group（26 cases），moderate group（39 cases） and severe group（65 cases） according to Fazekas score scale. The general data of the patients were collected，and the independent risk factors of WMH severity were analyzed by multivariate ordered logistic regression. Spearman rank correlation was used to analyze the correlation between WMH and cognitive impairment and the correlation between cognitive impairment and syndrome elements.[Results] The age and the proportion of diabetes patients in the moderate and severe group were higher than the mild group；the proportion of patients with remote cerebral infarction，the proportion of acute ischemic stroke patients and the proportion of patients with cognitive impairment in the severe group were higher than the mild group；the proportion of patients with carotid atherosclerosis with plaque in the severe group was higher than the mild and moderate group，with statistical significance（P＜0.05，P＜0.001）；the mini-mental state examination（MMSE） and the Montreal cognitive assessment（MoCA） score of the severe group were lower than the mild and moderate group；the clock drawing test（CDT） score of the severe group were lower than the mild group；the severe group had a higher activity of daily living（ADL） score than the mild group，with statistical significance（P＜0.05，P＜0.001）. After adjusting for the confounding factors，age（OR=1.105，95%CI：1.042~1.171，P=0.001），remote cerebral infarction（OR=6.567，95%CI：2.428~17.76，P＜0.001），acute ischemic stroke（OR=8.514，95%CI：2.625~27.617，P＜0.001）and the severity of deficiency of vital energy（OR=1.12，95%CI：1.007~1.245，P=0.036） were the independent risk factors of WMH severity. Spearman correlation analysis showed that the WMH severity was positively correlated with the proportion of cognitive impairment patients（rs=0.304，P＜0.001）；the total WMH score combined with cognitive impairment，the periventricular hyperintensity（PVH） score and the deep white matter hyperintensity（DWMH） score of the cognitive impairment were negatively correlated with the score of MMSE（rs=-0.358，rs=-0.388，rs=-0.301，P＜0.05） and MoCA（rs=-0.397，rs=-0.323，rs=-0.401，P＜0.05，P＜0.05）；the total WMH score was positively correlated with the score of ADL（rs=0.24，P＜0.05）；the DWMH score was negatively correlated with CDT score（rs=-0.247，P＜0.05）. The proportion of patients with cognitive impairment was positively correlated with the proportion of patients with deficiency of vital energy（rs=0.265，P＜0.05）. The MoCA score of the cognitive impairment was negatively correlated with the score of deficiency of vital energy（rs=-0.257，P＜0.05）. [Conclusion] Age，remote cerebral infarction，acute ischemic stroke and the severity of deficiency of vital energy are the independent risk factors of WMH severity；the more WMH serious，the higher risk and the greater degree of cognitive impairment；the deficiency of vital energy is the important syndrome element of cognitive impairment correlated with WMH. |
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