| Objectives: The characteristics of carotid atherosclerotic plaques and clinical characteristics of patients with acute cerebral infarction(such as neurological impairment,NIHSS score,infarct lesion size,infarct lesion number)were statistically analyzed.So as to provide reference value for stratified prediction of cerebral infarction risk.Methods: A total of 314 patients with acute cerebral infarction which admitted in Taizhou People’s Hospital were enrolled.Patients were divided into carotid plaque group(n=200)and non-carotid plaque group(n=114)according to presence of carotid plaque.The carotid plaque group was further divided into single plaque group(n=96)and multi-plaque group(n=114)according to the number of plaque,stable plaque group(n=69)and unstable plaque group(n=131)according to the stability of plaque,and CCA group(n=30),BIF group(n=15),ICA group(n=143)and ECA group(n=12)according to the location of plaque.Meanwhile,all patients with acute cerebral infarction were divided into mild group(n= 178)and moderate-severe group(n= 136)according to the degree of neurological impairment,single cerebral infarction group(n=167)and multiple cerebral infarction group(n=33)according to the number of infarcts shown in the cranial MR Image.According to the lesion size,patients were divided into lacunar infarction group(n=18),small and medium-size infarction group(n=132)and massive cerebral infarction(n=50).The clinical characters of patients were compared,and the characteristics of carotid artery plaque and clinical characteristics of cerebral infarction patients were analyzed statistically.Prognostic follow-up was conducted at two time points,half a year and one year after the onset of the disease,and the incidence of adverse outcomes after stroke in the carotid plaque group was evaluated.Results: There were significant differences in age(t=3.328,P< 0.001),hypertension(X~2=5.043,P=0.024),diabetes(X~2=5.069,P=0.026),blood glucose(Z=7.325,P<0.001),homocysteine(Z=8.849,P< 0.001)and diastolic blood pressure(Z=2.930,P=0.004)between carotid plaque group and non-carotid plaque group.Binary logistic regression analysis showed that patients with Acute cerebral infarction(ACI)were1.444 times more likely to develop plaques with every 1 mmol/L increase in blood glucose(95%CI:1.274-1.637,P< 0.001),1.343 times greater for each 1mmol/L increase in homocysteine(95%CI:1.223-1.475,P < 0.001).There were significant differences in age(t=5.425,P< 0.001),hypertension(X~2=12.930,P< 0.001),hyperlipidemia(X~2=4.511,P=0.038),blood glucose(Z=3.178,P<0.001)and homocysteine(Z=3.547,P<0.001)between the mild and moderate-severe groups.Among patients with cerebral infarction,the likelihood of developing moderate-severe ACI was 1.053 times(95%CI:1.028,1.079,P<0.001)for each increase in age of 1 year,1.998 times(95%CI:1.114,3.582,P=0.020)for patients with hypertension,1.070 times higher for each 1 mmol/L increase in blood glucose(95%CI:1.009,1.134,P=0.023),1.028 times higher for each increase of homocysteine(95%CI:1.001,1.055,P=0.039),and 1.926 times higher for those with plaque than non-plaque(95%CI:1.117,3.321,P=0.018).The probability of massive cerebral infarction with plaque was significantly higher than that patients without plaque(X~2=6.274,P=0.043).And the probability of moderate-severe cerebral infarction with plaque was significantly higher than that in ACI patients without plaque(X~2=3.878,P<0.001).The probability of massive cerebral infarction patients in the multi-plaque group was significantly higher than that in the single-plaque group(X~2=6.841,P=0.033),and the probability of moderate-severe cerebral infarction was significantly higher than that in the single-plaque group(X~2=4.439,P=0.035).The incidence of moderate-severe cerebral infarction in unstable plaque group was significantly higher than that in stable plaque group(X~2=5.030,P=0.025).The incidence of small and medium-size and massive cerebral infarction in ICA group was significantly higher than that in CCA group,BIF group and ECA group(X~2=14.934,P=0.021).Conclusions: In ACI patients,the occurrence of carotid atherosclerotic plaques was correlated with the degree of neurological impairment and lesion size,the number of plaques was correlated with the degree of neurological impairment and lesion area,the stability of plaques was correlated with the degree of neurological impairment,and the location of plaques was correlated with the lesion area of cerebral infarction.The number,stability and location of carotid plaques may possibly predict the severity of acute cerebral infarction which could provide reference value for early intervention of plaques to reduce the severity of ACI. |
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