Objective To investigate the risk factors for cerebral microbleeds（CMB） in patients with ischemic stroke caused by acute small artery occlusion（SAO）. Methods A total of 232 patients with SAO ischemic stroke admitted to a hospital in Nanyang from January 2019 to March 2021 were selected for the study

and they were divided into CMB group（78 cases） and no CMB group（154 cases） using susceptibility weighted imaging（SWI） technique

and the differences in clinical data

laboratory indexes

and imaging examinations between the 2 groups were compared. Multi-factor logistic regression was used to analyze the risk factors for the development of CMB in patients with SAO ischemic stroke. Results The incidence of CMB in patients with SAO ischemic stroke was 33.62%; among the patients with CMB

46（58.97%） were male and 32（41.03%） were female; a total of 352 CMB sites occurred

with an average of 4.57±1.06 sites per patient; they were distributed in the basal ganglia thalamic region（192）

lobar region（93）

and subscallosal region（67）. The mean number of CMB sites at each region per patient was 3.45±2.04

2.87±1.53

and 1.35±0.65; the numbers of CMB sites in the basal ganglia thalamic and lobar regions were significantly higher than that in the subcurtain region

and the difference was statistically significant（P <0.05）. The differences between patients in the CMB and no CMB groups were statistically significant（P<0.05） when comparing age

total cholesterol（TC） level

partial prothrombin time（APTT）

international normalized ratio（INR）

interleukin-6（IL-6）

high-sensitivity C-reactive protein（hs-CRP）

deep white matter hyperintensity（DWMH） score Multi-factor logistic regression analysis showed that age

hypertension

lacunar cerebral infarction

APTT

INR

IL-6 level

hs-CRP level

and DWMH score were risk factors for the development of CMB in patients with SAO ischemic stroke. Spearson correlation analysis showed that the number of CMB sites in SAO ischemic stroke patients was linearly and positively correlated with the number of lacunar cerebral infarct foci

DWMH score

APTT

INR

IL-6 level

and hs-CRP level（P<0.05）. the optimal threshold of ROC curve for TC level to predict the occurrence of CMB in SAO ischemic stroke was 4.91 mmol/L

when the sensitivity（75.49%） and specificity（90.85%） were the best. Conclusion Age

hypertension

lacunar cerebral infarction

APTT

INR

IL-6 level

hs-CRP level

and DWMH score are risk factors for the occurrence of CMB in patients with SAO ischemic stroke

and the number of CMB is positively correlated with related risk factors. TC level can be used as an auxiliary index for predictive diagnosis of CMB in patients with SAO ischemic stroke

and it is suggested that clinical monitoring of TC levels should be emphasized

and interventions should be implemented as early as possible to reduce the incidence of CMB

thereby enhancing clinical outcomes and improving prognosis.