A Study On Factors Related To Etiopathology, Evolvement And Outcome Of Ischemic Cerebral Vascular Disease

Objectives1. To learn about the general picture of patients with ischemic cerebral vascular disease(ICVD).2. To explore the integrated effects of related factors on etiopathology, evolvement and outcome of ICVD.Material and methods1. The general picture of 2005 consecutive patients with ICVD admitted to PLA General Hospital between 1990 and 1999 was described, x 2 test was employed to compare the distribution of risk factors among different subgroups of ICVD.2. The profile of "Hypertension History" and "Diabetes Mellitus History" in ICVD patients, which meant the time interval between onset of first symptomatic ICVD and establishment of diagnosis of hypertension and diabetes mellitus were respectively summarized. The related factors' influence on the length of "Hypertension History" and "Diabetes Mellitus History" was analyzed by means of multiple linear regression model.3. The clinical character and short-term prognosis or 396 patients admitted as transient ischemic attack (TIA) were summarized. The related factors' influences on short-term prognosis were studied by logistic regression model.4. The short-term prognosis of 1750 patients with cerebral infarction was summarized. The related factors' influences on short-term prognosis were studied by logistic regression model.5. The character of 199 ICVD patients aged up to 45 years was analyzed in comparison with those older than 46 years by univariate analysis.6. The character of 73 patients with hemorrhagic infarction was summarized. The logistic regression model was employed to find predictors of hemorrhagic transformation and to evaluate the influence of hemorrhagic transformation on short-term prognosis of cerebral infarction. Results1. 1365 male patients (mean age 60.56 ?1.18) compromised 68.1% and 640 female patients(mean age 63.57 ?13.05)compromised 31.9% of the 2005 patients(mean age 61.52 ?11.89).753 ( 37.6% ) patients were between 61 and 70 years ,which was the largest part if the patients were divided into subgroups by every ten years of age. In 1684 ( 84%) patients, ischemia was located in internal carotid artery (1CA) territory and 321 patients (16%) in vertebrobasilar artery (VBA) territory. Among subtypes of cerebral infarction classified by etiology ,lacunar infarct was the most frequent subtype(1065, 60.9%), which was followed by atherosclerotic thrombotic cerebral infarction (271, 15.5 %) and cerebral embolism ( 246, 14.1 % ) ,106 patients(10.5%) belonged to undetermined group. Hypertension was the most frequent risk factor found in 58.7% of patients ,which was followed by smoking (32.7%), hypertriglyceridemia (26.3%) , familial CVD history (23.1%), diabetes mellitus (16.5%) , hypercholesterolemia (14.3%), alcohol abusing (11.8%), atrial fibrillation(6.9%), and myocardial infarction(5.3%).No risk factor was found in 192 patients (9.6%). Smoking , alcohol abusing and myocardial infarction were more frequent in male while atrial fibrillation and hypercholesterolemia more frequent in female; Hypertension, diabetes mellitus, atrial fibrillation and myocardial infarction were more frequent in patients older than 45 years; The proportion of smoking and alcoholabusing decreased with increasing age; Hypertension, smoking, alcohol abusing, familial CVD history were more frequent while atrial fibrillation less frequent in patients with lacunar infarct than those with non-lacunar infarct. Distribution of risk factors between ischemia in CA and that in VBA territory was found to be of no significant difference .Hypertension atrial fibrillation, alcohol abusing were more frequent while smoking ,familial CVD history , hypertriglyceridemia less frequent in patients with infarction as the first ICVD than those with TIA as the first ICVD.Neuroimaging study revealed that supratentorial infarcts were most frequently located in basal ganglia territory and subtentorial infarcts most frequently in pons. Extracranial carotid artery stenoses were detected in 31.1% and intracrania...