Analyze The Risk Factors And Carotid Ultrasonic Characteristics Of Large Artery Atherosclerosis And Penetrating Artery Disease

Objective: To investigate the risk factors and carotid atherosclerosisultrasonography features of Large artery atherosclerosis (LAA) andPenetrating artery disease(PAD), aim to analysis the etiological diagnosisof ischemic stroke and its subtypes provide basis.Methods: Retrospective analysis the clinical data from the patientswith acute ischemic stroke, which from2012July to2013March in ThePeople’s hospital of Liaoning province. According to CISS classification,take the patients diagnosis of LAA or PAD as the object of study.Comparison of risk factors in the patients of the two groups, and analyzedthe carotid artery ultrasonography compared two groups of patients withextracranial carotid atherosclerosis and plaque incidence number, location,nature, Crouse integral, the degree of luminal stenosis. Analyze the riskfactors and carotid artery ultrasound of univariate and multivariate analysis.Result: Participants included214patients with acute ischemic stroke,LAA (n=109,51%), Cardiogenic stroke (n=61,28%), PAD (n=38,18%),Undetermined etiology (UE) and Other etiology (n=6,3%). Excluded45ofLAA and PAD, the final102cases were selected as the research object,65cases in LAA group, PAD group of37cases.Risk factors, the rate of diabetes in LAA is higher than PAD (X~2=4.76,P<0.05). Multivariate Logistic regression analysis showed, diabetes was theindependent risk factor of LAA, OR was2.9(95%CI1.06～7.88). Otherrisk factors liked age, sex, hypertension, smoking, drinking, history ofstroke and blood lipid had no statistical differences between LAA and PAD. Detection rate of carotid artery plaque. LAA (n=59,90.8%), in whichmultiple plaque in52cases (52/65,80%). PAD (n=23,62.2%), in whichmultiple plaque in21cases (21/37,56.7%). The detection rate and multipleplaque in LAA is higher than PAD (90.8%VS62.2%, P<0.01;80%VS56.7%,P<0.05). Unconditional Logistic regression analysis, the number of carotidartery plaque was the independent risk factor for LAA, OR was1.7(95%CI1.23～2.36). The distribution of carotid artery plaque, the detection rate ofipsilateral common carotid artery plaque were75%in LAA (49/65) vs PAD51%(19/37), ipsilateral carotid bulb in LAA was32%(32/61) vs PAD21%(8/37), ipsilateral internal carotid artery was12%in LAA (7/59) vs PAD0%.Different parts of the ipsilateral extracranial carotid artery plaque detectionrate of LAA were higher than PAD (P<0.05). The difference between twogroups in the common carotid artery and carotid bulb were significantly(P<0.01). On the side of lesion, the detection rate of carotid artery plaquewas72%in LAA (46/64) vs PAD43%(16/37), the difference between thesetwo groups was significantly (P<0.01), but there were no statisticaldifference between the carotid bulb and internal carotid artery.The carotid artery plaque Crouse integral, LAA (M=6.4) higher thanPAD (M=4.6)(Z=-2.92, P<0.05).102patients with carotid artery stenosis(>50%) were16cases (16%), LAA (n=14,22%), PAD (n=2,5%), there wereno statistical difference between them (X2=3.5, P>0.05). The ipsilateralcarotid artery stenosis, LAA (n=11,17%) was significantly higher than PAD(n=0)(P<0.01).The detection rate of unstable plaque, in ipsilateral carotidartery, LAA was higher than PAD (68%,44/65vs49%,18/37)(P<0.05); inipsilateral carotid bulb, LAA was higher than PAD (41%,27/65vs19%,7/37)(P<0.05). On the side of lesion, the common carotid artery in LAA detectedmore unstable plaque than PAD (64%,41/64vs38%,14/37)(P<0.05).Conclusion: LAA and PAD are the most common types of noncardiogenic in CISS classification. Both LAA and PAD have differentdegrees of CAS, while the CAS levels of patients with LAA were moresevere. The carotid artery stenosis, unstable plaques and ipsilateralatherosclerosis are particularly important for the classification of cerebralinfarction. The number of carotid artery plaque and diabetes are the independent risk factor for LAA.