Through a comparison between CMBs and non-CMBs groups,we found that age and IS were significantly associated with CMBs, and the older patients is more possibly occur CMBs,this result was consistent with some previous studies: The research of Poels MMF et al showed that there is significant associations between CMBs and advanced age, as well as hypertension[10].Rotterdam Scan Study described CMBs in 1,062 older subjects,CMBs were detected in 17.8% of patients aged 60–69, in 31.3% of patients aged 70–79, and in 38.3% of patients aged 80–97[11]. The prevalence of multiple CMBs was also found to increase significantly with age[12].A study from van Elderen et al.[13]demonstrated the brain atrophy is age-associated,so in our study,brain atrophy has been enrolled to analysis,the comparison between the two groups showed that a significant difference but it’s not a independent predictor of CMBs.
Previous research about the prevalence of CMBs in IS patients were variety[14–16].The research of Kim et al.[17] showed the prevalence of CMBs in elderly subjects with no history of cerebrovascular disease is around 5%, but is much higher in patients with ischemic or hemorrhagic stroke.In our study,the result showed that patients with a history of IS is an independent risk factor for CMBs,that is consistent with their finding.
The study of Lee et al. [18]reported that patients with ICH after warfarin treatment yielded a conclusion that increase in INR aggravated the occurrence of CMBs. The study of Zhang, H et al.[19]with 174 cases found that APTT was an independent risk factor for CMBs in patients with intracerebral hemorrhage,but another study conducted by Liu et al.[20]showed that the levels of APTT and TT were without a significant difference between CMBs group and non-CMBs group. In our study,193 cases was enrolled and the result showed INR was the only coagulation function index which has a significant difference between CMBs group and non-CMBs group,but in the subsequent logistic regression analysis showed that it was not a independent predictor of CMBs,these previous studies indicates that there may be a direct relationship between CMBs and coagulation function,but consensus was still insufficient in confirming which kind of coagulation index is or are the optimal representation.
Many previous researches reported that patients on antithrombotic treatment with a higher risk of hemorrhagic complications,similarly, CMBs were found to be more frequent and extensive in patients with aspirin-associated ICH[21],in a cross-sectional study, CMBs were more common in patients underling an antithrombotic treatment, and aspirin use was found to be related to a lobar location[22].reference to these previous studies,a long-term history of antithrombotic treatment were included in our study and there was a significant difference between the two groups though its prediction effect was not ideal,and Spearman correlation analysis was used between INR and AT,the result showed the correlation coefficient is 0.235,P < 0.05,indicated that the direct relationship between the two factors.
Limitation is inevitable in this study:First,our sample size is relatively small,and only Asian patients were included in the study,non-Asian patients may yield a different association between CMBs and coagulation function, a multicentre research is expected conducting in the future.Second,our study proved that antithrombotic treatment has an association with the occurrence of CMBs,but we haven’t discriminated which kind of it(anticoagulant,antiplatelet or thrombolytic drugs),it deserve to do a more explicit analysis.Third,our study mainly inflected the phenomenon that some coagulant factor affected CMBs of patients with ICH,however, so far there is still lack of some mechanism studies to illustrate the phenomenon,a targeted study will be needed in the future.