1.Investigation Of The Relationship Between Peripheral Artery Stenosis And Cardio-cerebrovascular Events

Part 1 Investigation of the relationship between peripheral artery stenosis and cardio-cerebrovascular eventsObjective-To investigate the development and distribution of atherosclerosis in elder people,analyze the correlation between cardio-cerebrovascular events and periphery artery stenosis to identify the people with higher risk of developing events in the future.Methods-A cross-section study was performed which enrolled 840 subjects aged more than 60years(median age 70).Record the clinical data including general state of health,cardio-cerebrovascular events and risk factors concerned.Record the peripheral vascular ultrasound at the same time.Results-In elder people,the prevalence of cerebrovascular events was 7.6%and cardiovascular events was 10.1%.The artery stenosis of carotid,renal and lower extremity was identified in 19(5.0%),13(5.5%)and66(23.4%)respectively.The prevalence of cardio-cerebrovascular events and peripheral artery stenosis increased with age rising in both sexes,and the difference was significant among every age group(P＜0.001).The more numbers of peripheral artery stenosis,the more events occurred(P＜0.001). Cardiovascular events were associated with artery stenosis of carotid and lower extremity (P＜0.001).Results of Logistic regression analyses indicated that the significant differences remain existed including age,artery stenosis of lower extremity, hyperlipoidemia and smoking.The odds ratio for patients in the highest quartile compared with those in the lowest quartile were 1.056(95%CI 1.016-1.019), 2.262(95%CI1.024-4.996),2.924(95%CI1.325-6.455) and 2.262(95%CI 1.042-4.912) respectively for the above four risk factors.It manifested intensive correlation between artery stenosis of lower extremity and ischemic cerebrovascular events(P＜0.05).Age, independent of other known risk factors,played the most important role in ischemic cerebrovascular events(OR=1.046,95%CI 1.007-1.085).Conclusions-The prevalence of cardio-cerebrovascular events and peripheral artery stenosis increased with the age rising.The more numbers of peripheral artery stenosis, the more events occurred.Age,the artery stenosis of carotid and lower extremity were the significant factors to cardiovascular events independent of other known risk factors, while age played the most important role in ischemic cerebrovascular events. Part 2 Investigation of the relationship between soluble cellular adhesion molecules and ischemic strokeObjective-To assess the different levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1(sVCAM-1) in ischemic stroke in order to evaluate the prognostic value.Methods-A case-control study was performed.We studied 39 patients with recurrent ischemic stroke,37 with stable ischemic stroke and 46 with asymptomatic intracranial artery stenosis.Concentrations of serum sICAM-1 and plasma sVCAM-1 were measured using an enzyme linked immunosorbent assay(ELISA) technique as well as the levels of serum hs-CRP at the same time.Results-Significantly Higher levels of sICAM-1 and sVCAM-1were observed for the patients with stable and recurrent ischemic stroke(sICAM-1:460 and 446ng/mL, sVCAM-1:939.27 and 875.03ng/mL) compared with the asymptomatic subjects (sICAM-1:355ng/mL,sVCAM-1:743.28ng/mL)(P＜0.05),but the distributions were not notably different between the stable and recurrent cases.As for hs-CRP,the serum concentrations significantly elevated in recurrent cases(median:2.34mg/L) compared with the stable and asymptomatic subjects(medians:1.45 and 1.31mg/L)(P＜0.05),while no significant difference was observed in the later two.And there was no correlation between either two of sICAM-1,sVCAM-1 and hs-CRP.Conclusions The levels of sICAM-1 and sVCAM-1 were significantly higher in stable and recurrent ischemic stroke compared with the asymptomatic subjects,while the hs-CRP concentrations notably elevated in recurrent cases than stable and asymptomatic subjects.