Analysis Of Risk Factors Between Intracranial And Extracranial Atherosclerosis In Patiets With Ischemic Cerebralvascular Diseases

Part 1 Relationship between plasma homocysteine level and carotid atherosclerosis in old patients with acute cerebral infarctionObjective: To investigate the relationship between plasma homocysteine (Hcy) levels and the plaque and its degree of the carotid atherosclerosis (CAS) in elderly patients with acute cerebral infarction (ACI).Methods: 93 definit ACI patients recieved the colour Doppler ultrasonograph to detect the intima-media thickness (IMT) of bilateral carotid arteries. Then, the patients were divided into group with CAS plaque (60 cases) and group without CAS plaque(33 cases) according to the result of the detection. Also the degree of CAS were divided to 0～4 levels. The concentration of plasma Hcy of all the patients were measured by enzymatic cycling assay. The correlation analysis was made between plasma Hcy levels and the CAS plaque and the degree of CAS.Results: The concentration of plasma Hcy in the group with CAS plaque [18.83(15.20～24.03)umol/L] was significantly higher than that in group without CAS plaque[12.30(9.70～15.10)umol/L] (P<0.05). The incidence of hyperhomocysteinemia in the group with CAS plaque was also significantly higher than that in group without CAS plaque (P<0.05). The concentration of plasma Hcy in 3 degree of CAS compared with 0～1 degree, in 4 degree of CAS compared with 0～2 degree were reached the statistic significance(all P<0.005). Conclusions: The formation of CAS plaque may be closely associated with the increased level of plasma Hcy in the elderly patients wit ACI. The higher CAS degree is the more correlation exist.part 2 Comparative analysis of risk factors between intracranial and extracranial atherosclerosis in patients with ischemic cerebrovascular diseasesObjective: To compare the differences of the risk factors between intracranial and extracranial atherosclerosis in patients with ischemic cerebrovascular diseases, so as to interfere with thess factors precisely.Methods: A sample of one hundred and twenty-four subjects with ischemic cerebrovascular diseases was selected and examined using TCD,MRI and Color Doppler ultrasound. Based on the test results, the subjects were then divided into two group: only intracranial atherosclerosis group and only extracranial carotid atherosclerosis group; intracranial atherosclerosis group were divided into intracranial small vessels atherosclerosis and large vessels atherosclerosis subgroup; intracranial or extracranial carotid atherosclerosis group was divided into two subgroups in accordance with the gender. T test,χ2 test and Kruskal-Wallis H-test of the two groups of variables are employed to give a comparative analysis of the differences among the risk factors of both groups and subgroups.Results: (1)The prevalence of the hypertension (65.8%) in only intracranial atherosclerosis group was more than that(33.3%) in only extracranial carotid atherosclerosis group. (2)The concentration of plasma Hcy [17.51(12.68～21.13) umol/L] and age(73.57±11.83岁) in only extracranial carotid atherosclerosis group were more than that[13.29(10.18～17.43) umol/L,68.76±7.23] in only intracranial atherosclerosis group. (3)The prevalence of the hypertension (64.30%) in intracranial small vessels atherosclerosis subgroup was more than that (21.90%)in intracranial large vessels atherosclerosis subgroup. (4) The differences of the risk factors between male subgroup and female subgroup are that the concentration of plasma Hcy[17.14(23.10～12.63)umol/L] in male subgroup was more than that[14.01(16.53～10.88)umol/L] in female subgroup; the concentration of plasma of LP(a) [0.18(0.30～0.10)mg/mL] in female subgroup in critique age was more than that[0.11(0.23～0.07)mg/mL] in male subgroup ,all the dates reached statistic significance(P<0.05).Conclusions : Among various risk factors attributable to ischemic cerebrovascular diseases metioned above, the hypertension is a significant one that can enhance intracranial atherosclerosis and can ,in particular, contribute to intracranial small vessels atherosclerosis; The intensified concentration of plasma Hcy and aging are two important risk factors accountable for formation of extracranial carotid artery atherosclerosis; The higher concentration of plasma Hcy in male subgroup than female counterpart indicates their greater vulnerability to the disease involved while the distinct concentration of plasma of LP(a) in post-menopausal females exhibit a more sensitive and close relation to formation of intracranial and extracranial atherosclerosis.