The Clinical Study On Relationship Between Carotid Atherosclerosis And Acute Cerebral Infarction

Objective:Based on the cerebral infarction in patients with carotid artery ultrasound to discuss the relationship between the carotid atheros-clerosis and the cerebral infarction. According to blood pressure, blood glucose, blood lipids, etc, study the risk factors of atherosclerosis.Methods:256 patients with acute non-progressive cerebral infarction, 50 patients with progressive cerebral infarction,100 patients with non-cerebrovascular disease (such as Parkinson's disease, motor neuron disease, peripheral neuropathy, myelopathy, etc.) as non-progressive cerebral infarction group, progressive cerebral infarction group and control group were treated in The Second Affiliated Hospital of Dalian Medical University, Department of Neurology during April 2008 to October 2009. All the patients were conventionally measured blood pressure, blood glucose, blood lipids (including total cholesterol TC, triglyceride TG, low density lipoprotein cholesterol LDL-C, high density lipoprotein cholesterol HDL-C) and the carotid ultrasonography.Some factors which included vessel diameter, vessel wall intima-media thickness (IMT), with or without atherosclerotic plaque, plaque echo intensity, location, shape, size, quantity, whether luminal stenosis and its degree were measursd.Results:1 The detection rate of plaque in progressive cerebral infarction group was 90%, soft plaque was 74%; the detection rate of plaque in non-progressive cerebral infarction group was 78.9%, soft plaque was 58.6%; the detection rate of plaque in control group was 45%, soft plaque was 9%. Difference among the three groups was significant (P<0.05). The detection rate of the mixture plaque, hard plaque and IMT thickening was no significant difference (P>0.05).2 The 96% patients in progressive cerebral infarction group had artery stenosis, of which 16 cases(32%) had severe stenosis; The 84.4% patients in non-progressive cerebral infarction group had artery stenosis, of which 32 cases(12.5%) had severe stenosis; The 56% patients in control group had artery stenosis, of which 4 cases(4%) had severe stenosis.Difference among the three groups was significant (P<0.05).3 In non-progressive cerebral infarction group, the plaque numbers between cerebral infarct side and non-infarction side were no significant difference (P>0.05). Soft plaque detection rate in infarction side was 58.8%, and the severe stenosis was 38.8%, which was higher significant than non-infarct (P<0.01).4 In the common risk factors of atherosclerosis, at p= 0.05 level, the results showed that age, male, hypertension, diabetes, LDL-c increaseing were risk factors.Conclusion:1 Carotid atherosclerosis in ischemic cerebrovascular disease was an important risk factor. Domestic and Overseas study all agreed that the occurrence of ischemic cerebrovascular disease was not only about the degree of vascular stenosis, but also the nature of arterial plaque. This study showed that cerebral infarction in patients with carotid atherosclerosis, soft plaque and severe arterial stenosis was higher than that of non-cerebral infarction, consistent with the literature.2 Overseas studies have reported, the nature of atherosclerosis and the degree of arterial stenosis was closely related of progressive cerebral infarction. This study shows that the incidence of carotid atherosclerotic plaque and severe arterial stenosis in progressive cerebral infarction group was significantly higher than the non-progressive cerebral infarction group, particularly high incidence of soft plaque. In this study,8% of patients with progressive cerebral infarction not detected in atherosclerotic plaques, considering the reason was related to the systemic factors, such as high blood glucose, fever, infection, etc.3 This study showed that cerebral infarction was not related to the. incidence of atherosclerosis and artery stenosis between infarct side and non-infarct side, but related to the nature of the plaque and the degree of arterial stenosis, which indicated that the nature plaque and the degree of arterial stenosis could reflect cerebral vascular disease whether at high risk status.4 This study again confirmed that age, male, hypertension, diabetes, LDL-c increaseing were risk factors of atherosclerosis, and also showed ischemic cerebrovascular disease was a multi-factor complex interaction. Many studies have shown that smoking was also an atherosclerosis risk factor, this study did not come to this conclusion. Although some patients considered themselves not smoking, but long-term exposure to smoking environment could cause atherosclerosis.