Objective  To explore the rules of association and factors influencing the main symptoms of hospitalized patients with cerebral small vessel disease.

Methods Clinical data of 240 patients with cerebral small vessel disease who were hospitalized in the Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University from January 2020 to June 2024 were retrospectively analyzed. The main symptoms were extracted, and the Apriori algorithm was used for symptom association rule analysis. Binary logistic regression analysis was then performed to identify the influencing factors of the main symptoms.

Results The five main symptoms associated with cerebral small vessel disease were dizziness (69.6%), poor sleep quality (44.5%), headache (28.7%), sensory abnormalities (23.3%), and limb weakness (22.1%), respectively. Association rule analysis revealed that dizziness, poor sleep quality, headache, unsteady gait, nausea, vomiting, limb weakness, and chest tightness were mutually associated. Logistic association analysis demonstrated that age≥75 (OR = 3.304) was an independent risk factor for dizziness. Elevated serum amylase (OR = 1.013), chest tightness (OR = 4.948), and the presence of malnutrition risk (OR = 4.477) were the risk factors for poor sleep quality. Poor sleep quality (OR = 1.979) was an independent risk factor for headache (P ＜ 0.05).

Conclusions Patients with cerebral small vessel disease present with a complex and diverse array of symptoms that are highly interconnected. Greater attention should be paid to dizziness in elderly patients, while also focusing on sleep issues in those at risk of malnutrition or with elevated amylase levels, as well as the correlations between sleep and symptoms such as chest tightness and headache. Comprehensive symptom management must be strengthened.