Analysis Of The Distribution Characteirstics And Risk Factors Of Intra-and Extra-cranial Artery Atherosclerotic Stenosis In29189Cases In Jilin Province

Background and Objective: Intra-and extra-cranial artery atherosclerotic stenosis is animportant risk factor of ischemic cerebrovascular diseases (ICVD) and atherosclerotic lesions inthe cerebral arteries are distributed heterogeneously among different races. This study aims toinvestigate the distribution characteristics and risk factors of intra-and extra-cranial arteryatherosclerotic stenosis in population of Jilin Province with combined utilization of carotid arterycolor Doppler ultrasound and TCD.Methods: The trial selected29,189consecutive cases who visited the doctors in the1stHospital of Jilin University from January2011to October2013as the research objects, all ofwhom had been carried on cerebrovascular examination with both carotid artery color Dopplerultrasound and TCD. By comprehensive analysis, we wanted to evaluate the distribution ofcerebral artery atherosclerotic steno-occlusive lesions. For a further study on the risk factors ofintra-and extra-cranial atherosclerosis,1,257cases who had been hospitalized in our hospital in2013were randomly chosen and their clinical data was collected and analyzed.Results:①Overall distribution: Of all the29,189cases,7,725cases (26.5%) hadintracranial artery stenosis, while5,044cases (17.3%) had extracranial artery stenosis (P=0＜0.05).5,130cases (17.6%) had only intracranial artery stenosis,2,449cases (8.4%) had onlyextracranial artery stenosis, and2,595cases (8.9%) had both. Mild stenosis(8,400/13,164=63.8%) was most common in intracranial lesions, while severe stenosis orocclusion (3,673/8,809=41.7%) in extracranial lesions (P=0＜0.05).8,193cases (28.1%) hadanterior circulation artery stenosis, while5,223cases (17.9%) had posterior circulation arterystenosis (P=0＜0.05). Among the intracranial arteries MCA was most prone to stenosis(7,432/21,973=33.8%), while as for extracranial arteries E-ICA was most common(3,399/21,973=15.5%), of which the initial segment was most likely to stenosis(2,803/3,399=82.5%)(P=0＜0.05).②Gender differences: Of17,140males,6,877ones (40.1%) had stenosis, while of12,049females,3,297ones (27.4%) had stenosis (P=0＜0.05). Theproportion of severe stenosis or occlusion in males was34.0%, and it was24.7%in females (P=0＜0.05).③Age differences: Of3,736cases in young-aged group (＜45years),705ones (18.9%)had stenosis, and the proportion of simplex intracranial stenosis was74.6%; Of12,383cases inmiddle-aged group (45～59years),3,777ones (30.5%) had stenosis, and the proportion ofsimplex intracranial stenosis was58.7%; Of13,070cases in old-aged group (≥60years),5,692ones (43.6%) had stenosis, and the proportion of simplex intracranial stenosis was41.9%(P=0＜0.05). The proportion of MCA decreased with age (55.4%,39.3%,28.7%), while that of E-ICAincreased (9.6%,13.1%,17.4%)(P=0＜0.05).④Risk factors: The male (P=0.020, OR=1.505),history of hypertension (P=0.004, OR=1.554) and diabetes (P=0.000, OR=1.833) wereindependent risk factors for simplex intracranial stenosis and hypertension grade (P=0.010,OR=1.181) as well as duration of diabetes (P=0.001, OR=1.052) was closely related to it; Age(P=0.000, OR=1.043) was the independent risk factor for simplex extracranial stenosis; The male(P=0.000, OR=2.290), age (P=0.000, OR=1.052), history of diabetes (P=0.025, OR=1.578) andsmoking (P=0.017, OR=1.652) were independent risk factors for coexistent stenosis. For males,the independent risk factors were age (P=0.000, OR=1.032) and history of diabetes (P=0.004,OR=1.656); for females, it was the history of hypertension (P=0.000, OR=2.348).Conclusions:①In our study, the incidence of intracranial artery stenosis was higher thanthat of extracranial, and simplex intracranial stenosis was most common; Compared with theposterior circulation arteries, the anterior circulation arteries were easier to stenosis; Thedifference between the incidence of artery stenosis on the left and that on the right didn’t reachthe level of statistical significance.②Among the intracranial arteries MCA was most prone tostenosis, while as for extracranial arteries E-ICA was most common, especially the initialsegment of ICA; What’s more, the incidence of MCA stenosis was higher relative to E-ICA;However, the proportion of MCA decreased with age.③Gender differences: The incidence ofstenosis in males of different ages was higher than that in females significantly. The proportionof severe stenosis or occlusion in males was higher than that in females.④Age differences: Theincidence of stenosis in young-aged group was low and the proportion of simplex intracranialstenosis was relatively high; The incidence of stenosis increased with age and so did theproportion of the simplex extracranial stenosis and coexistent ste nosis.⑤Mild stenosis was most common in intracranial lesions, while severe stenosis or occlusion in extracranial lesions.⑥Risk factors: The male, history of hypertension and diabetes were independent risk factors forsimplex intracranial stenosis; Age was the independent risk factor for simplex extracranialstenosis; The male, age, history of diabetes and smoking were independent risk factors forcoexistent stenosis. For males, the independent risk factors were age and history of d iabetes; forfemales, it was history of hypertension.