| Background and ObjectiveProgressing ischemic stroke (PIS) involving multiple factors is becoming a difficult point in the therapy of cerebrovascular diseases, which has a higher morbidity and mortality. The past study found that carotid atherosclerosis and inflammation were concerned with the disease.Therefore the purpose of this study was to analyze the sonographic features of carotid atherosclerosis.and the expression of inflammatory markers in patients with ischemic stroke (IS), and to explore ways of early PIS.Methods140 first acute IS inpatients were monitored after signing the consent form and divided into two groups:progressing ischemic stroke group (PIS) consisted of 43 patients and non-progressing ischemic stroke group (non-PIS) consisted of 97 cases. All Inpatients were performed by carotid ultrasonography in 24 hours after hospitalizing, and the severity of carotid atherosclerosis were evaluated based on the indexes of morphology, hemodynamics and ultrasound-physiology, in whom serum concentration of high-sensitivity C-reactive protein (HsCRP) and Serum ferritin(SF) were measured respectively on the next, the 3rd, the 7th and the 14th day after hospitalizing. The difference of echocardiographic parameters and serum markers were compared between PIS and non-PIS. SPSS 13.0 software was used to do statistical analysis,α=0.05 as significant level.Resultsl.The indicators of morphology were compared between PIS and non-PIS. Unstable plaque scores (χ2=4.0509,P<0.01), plaque eccentricity indexes (χ2=14.9619,P<0.01),IMSCA (t=2.9823,P<0.01), middle and heavy stenosis of carotid artery rate (χ2=16.2911,P<0.01),blood vessel negative remodeling ratio (χ2=7.6318, P<0.01)and so on. There was a significant difference between them (P <0.05)2.The parameters of hemodynamics were compared between PIS and non-PIS. The peak flow velocity of carotid stenosis (Vs, t=3.4051,P<0.01), the ratio between stenosis and far from stenosis peak flow velocity (Vs/Vp, t=2.7828, P<0.01), the ratio between peak systolic velocity (SPV) and end-diastolic velocity (EDV) (Vs/ Vd, t=2.2214,P<0.05),the ratio of peak flow velocity between internal carotid artery (ICA) and common carotid artery (CCA)(VICA/VCCA, t=2.1042, P<0.05), resistivity index (RI, t=2.4427, P<0.05). There was a significant difference between them (P <0.05)3.The indicators of ultrasound-physiology were compared between PIS and non-PIS. Arterial stiffness index (β, t=3.4834, P<0.01), distensibility factor (Dc, t=2.4660, P<0.05),compliance factor (Cc, t=3.0222, P<0.05). There was a significant difference between them (P<0.05).4.Levels of HsCRP:The proportionality of rising levels of HsCRP in PIS on the first, the third,the seventh and the fourteenth day after hospitalizing were 39.5% (17/43),74.4%(32/43),58.1%(25/43) and 30.2%(13/43); While the proportionality in non-PIS were 28.9%(28/97),31.9%(31/97),34.0%(33/97) and 20.6%(20/97). There was a significant difference between them on the 3rd and the 7th day (P<0.05).5.Levels of SF:The proportionality of high levels of SF in PIS on the first, the third,the seventh and the fourteenth day after hospitalizing were 44.2%(19/43), 62.8%(27/43),48.8%(21/43) and 30.2%(13/43); While the proportionality in non-PIS were 23.7%(23/97),21.6%(21/97),19.6%(19/97) and 12.4%(12/97). There was a significant difference between them on the next, the 3rd, the 7th and the 14th day (P<0.05).Conclusions1.Carotid atherosclerosis and the rising levels of HsCRP and SF on inchoate are risk factors of PIS.2.The combination of carotid ultrasonography and the levels of HsCRP & SF is conducive to detecting PIS.
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