SWE Evaluation Of Large Atherosclerotic Cerebral Infarction And Carotid Atherosclerotic Plaque Stability

Background :In recent years,cerebrovascular disease(CVD)has become the first cause of fatal diseases in China,and it is also the single disease with the largest disability rate.Stroke is the main clinical type of CVD.Carotid artery as the ’ windows ’ of Medium-sized arteries throughout the body Objective,Carotid atherosclerosis is not only a sign of systemic atherosclerosis,it can reflect the severity of systemic atherosclerosis,and carotid atherosclerosis is obviously related to the occurrence of Acute ischemic stroke,and it is a predictive factor of Acute ischemic stroke.Therefore,assessing the stability of carotid atherosclerotic plaque has important clinical significance for the prevention of Acute ischemic stroke.As a new ultrasound technology,SWE not only has the advantages of traditional ultrasound in the assessment of carotid artery plaque,but also provides quantitative indicators for the assessment of carotid artery plaque stability.Objective :Compare the elastic modulus of carotid atherosclerotic plaque between the two groups of participants,To Explore whether SWE can be used for the assessment of carotid atherosclerotic plaque;To explore whether the elastic modulus of carotid atherosclerotic plaque is an independent risk factor for LAA cerebral infarction.Methods :After this study was approved by the Ethics Committee of Shaanxi Provincial People’s Hospital,39 patients with first major atherosclerotic cerebral infarction and carotid artery plaque who were hospitalized in the Department of Neurology of Shaanxi Provincial People’s Hospital from January to December 2020 were included as the observation group.At the same time,68 patients with carotid plaque but no cerebral infarction were included as the control group.Both groups of candidates met the inclusion and exclusion criteria,All tests were performed with the consent of the patient.In this study,the clinical data of the two groups,including sex,age,past medical history,family history were analyzed and compared by case-control study.TC,TG,LDL-C and HDL-C of all participants were detected by fasting venous blood.The TPRS score table was used to score all carotid atherosclerotic plaques of each candidate,and the target plaque was selected.SWE measurement was performed on the target plaque to obtain Emax,Emean and Emin.The counting data were expressed as percentage(%),and the chi-square test was used.The measurement data were represented by the median(minimum,maximum),and nonparametric rank test is used.Logistic regression analysis was used to identify the risk factors of Large atherosclerotic cerebral infarction.The difference was statistically significant(P<0.05).All the data were analyzed by SPSS26.0 statistical software.Results:1.According to the inclusion and exclusion criteria,107 patients were included in this study,including 39 in the observation group and 68 in the control group.There were no statistically significant differences between the two groups in age,history of drinking,history of hypertension,hyperlipidemia,and family history.But there were statistically significant differences in gender,smoking history,and diabetes;2.In the comparison of blood biochemical results,LDL-C concentration of observation group was higher than control group(P<0.001),HDL-C concentration was lower than control group(P=0.002).There was no significant difference in TC concentration and TG concentration between the two groups(P=0.214,P=0.062).3.In the carotid atherosclerotic plaque SWE test results,Emax,Emean and Emin in the observation group were lower than those in the control group,and the difference was statistically significant(P=0.002,P<0.001,P<0.001).4.Single-factor logistic regression analysis showed that men,smoking history,and diabetes history were risk factors for large atherosclerotic cerebral infarction(P=0.008,P=0.032,P=0.014).Increased LDL-C and decreased HDL-C were risk factors for large artery atherosclerosis cerebral infarction(P=0.026,P=0.032).Decreased Emax,decreased Emean,and decreased Emin were risk factors for large atherosclerotic cerebral infarction(P=0.001,P<0.001,P<0.001).5.Multivariate logistic regression analysis showed that history of diabetes and elevated LDL-C were independent risk factors for large atherosclerotic cerebral infarction(P=0.005,P=0.002).Reduced HDL-C,reduced Emean,and reduced Emin were independent risk factors for large atherosclerotic cerebral infarction(P=0.006,P=0.008,P<0.001).6.According to the history of hypertension,the control group was divided into a group with a history of hypertension and a group without a history of hypertension,Comparison between the two groups,It was found that the Emax,Emean,and Emin of the group with a history of hypertension were higher than those of the group without a history of hypertension,and the difference in Emax between the two groups was statistically significant(P=0.03).7.According to the history of hyperlipidemia,the control group was divided into a group with a history of hyperlipidemia and a group without a history of hyperlipidemia,Comparison between the two groups,It was found that the Emax,Emean,and Emin of the group with a history of hyperlipidemia were higher than those of the group without a history of hyperlipidemia,and the Emean difference between the two groups was statistically significant(P=0.042).Conclusion:1.Men,history of smoking,history of diabetes,increased LDL-C,and decreased HDL-C are risk factors for large atherosclerotic cerebral infarction.2.SWE can be used as an index to assess carotid artery plaque.Decreased Emax,Emean,and Emin are risk factors for large atherosclerotic cerebral infarction.3.Diabetes history,increased LDL-C,decreased HDL-C,Emean,and Emin are independent risk factors for LAA cerebral infarction.