The Comparative Study Of Arterial Lesions Between Ischemic Stroke And Cerebral Arteriosclerosis Patients

Objective This study choosed ischemic stroke and cerebral arteriosclerosis patients examined by transcranial doppler and carotid chromatic ultrasound to compare arterial lesions between ischemic stroke and cerebral arteriosclerosis patients.Methods We selected 57 ischemic stroke patients with the age from 40 years to 59 years, and 97 sex and age-matched cerebral arteriosclerosis patients diagnosed by clinic symptoms and ultrasound, excluding polycythemia vera, diabetes,severe heart,liver and kidney disease, fibrillation atrial, arteritis, cerebral hemorrhage, brain tumors, brain injury, patients not penetrated by ultrasound through the temporal pillow window and not coped with ultrasound examination. At the same time, we set a control group with sex and age matched,who had no significant signs of the nervous system, no abnormality of blood glucose,blood lipids,blood pressure,electrocardiogram and funduscope,not taking the drugs which were affecting blood flow velocity,no abnormality on carotid chromatic ultrasound and transcranial doppler. Using 2MHz pulse doppler probe through bilateral temporal windows and pillow windows, the blood flow velocity (Vp,Vd,Vm),pulsatility index(PI),resistance index(RI),S/D of Basilar artery(BA) and bilateral middle cerebral artery(MCA) were detected, BA and MCA respectively as the representative of the anterior circulation and the posterior circulation of intracranial artery.In TCD spectrum, we selected the spectrum of a single-family cardiac cycle, identified the starting point(t0),the pulse-incisure point(ti) and end point(te),the peak velocity point(tp), measured the time of the spectrum starting point to the peck velocity point(TP) and then calculated the time required of the peak velocity in the share of ventricular systolic(PTI-1)as well as the time required of the peak velocity point in the share of the whole cardiac cycle(PTI-2).Using 10MHz carotid chromatic ultrasound probe, bilateral common carotid artery(CCA) and internal carotid artery(ICA) were detected. We measured the bilateral intima-medial thickness of CCA on the place from carotid bifuracation 1.5cm and recorded the amount,size and location of atheromatous plaques,beside the characteristics and stenosis ratio.All data was analyzed by SPSS13.0 statistical software.Results 1.Compared with the control group:IMT of carotid artery in ischemic stroke group was thickened significantly(P<0.05),while in group of cerebral arteriosclerosis, there was no significant difference (P>0.05);the PTI-1,PTI-2 of LMCA,RMCA,BA in both of groups were significantly increased.2.Compared with the cerebral arteriosclerosis group:the rate of fundus oculi arteriosclerosis in ischemic stroke group was not significantly increased(P>0.05).The difference of myocardial ischemia proportion was significantly between cerebral arteriosclerosis group and ischemic stroke group. IMT of carotid artery in ischemic stroke group was thickened significantly(P<0.05),there were more atheromatous plaques in ischemic stroke group(P<0.05),the plaques size scores were higher(P<0.05),and stenosis ratio between the two groups was significantly different(P<0.05).In ischemic stroke group, there were 44 plaques,23 stabile plaques,21 unstabile plaques,26 plaques located in the left carotid artery,18 plaques located in the right carotid artery. In cerebral arteriosclerosis group, there were 40 plaques,18 stabile plaques, 22 unstabile plaques,26 plaques located in the left carotid artery,14 plaques located in the right carotid artery.3.Compared with the cerebral arteriosclerosis group:the rate of abnormal TCD spectrum in ischemic stroke group was significantly increased(P<0.05).In ischemic stroke group, S2≥S1 waves accounted for 69.35%,circular and blunt contraction waves 28.23%,peak-time delay waves 2.42%.The PTI-1 and PTI-2 were significantly increased in the anterior circulation of ischemic stroke group(P<0.05).The PTI-1 and PTI-2 of circular and blunt contraction waves between the two groups were significantly different (P>0.05).4. The location of arteriosclerosis between ischemic stroke group and cerebral arteriosclerosis group was significantly different. In ischemic stroke group,almost 25 patients (43.86%) had carotid atherosclerosis complicated with cerebral arteriosclerosis.In cerebral arteriosclerosis group, almost 62 patients (65.26%) had cerebral arteriosclerosis.5. Logistic regression model analysis:All the ORs of myocardial ischemia,IMT,stenosis ratio,anterior circulation PTI-1/PTI-2 and location of arteriosclerosis were>1.The ORs of anterior circulation PTI-1/PTI-2 were 2.57 and 1.99.Conclusion Myocardial ischemia,IMT,stenosis ratio,anterior circulation PTI-1/PTI-2 and location of arteriosclerosis were significantly different between cerebral arteriosclerosis group and ischemic stroke group. All of them may be associated with ischemic stroke happened in cerebral arteriosclerosis patients.