| objective Discuss the correlation between the cardio ankle vascular index and the risk of ischemic stroke;To evaluate whether CAVI can be used as an indicator of massive cerebral infarction in patients;The correlation between cardio ankle vascular index and the risk factors of ischemic stroke was also analyzed.Methods 362 patients with ischemic stroke and 127 patients without ischemic stroke were selected to compare the heart and ankle vascular index between the two groups to understand whether there was a difference between the two groups.The subjects were followed up and observed for 2.5 years,COX regression analysis was used to analyze the relationship between CAVI and ischemic stroke;362 cases of ischemic stroke were divided into massive cerebral infarction group(78 cases)and non massive cerebral infarction group(284 cases)according to the results of head CT,The cardio ankle vascular index between the two groups was compared,evaluate whether CAVI can be used as an indicator of massive cerebral infarction in patients;Pearson correlation analysis and multiple linear regression analysis were used to explore the effects of blood pressure,blood sugar,uric acid,blood lipid and homocysteine on CAVI in patients with stroke.results1 Comparison of the risk factors of 362 cases with ischemic stroke group and 127 patients without ischemic stroke group,CAVI,total cholesterol,low density,uric acid,fasting blood glucose,systolic blood pressure and homocysteine in ischemic stroke group was higher than that of non ischemic stroke group(CAVI 11.71 ± 2.60 VS 9.79 ± 1.88,t=5.044,P < 0.001;total cholesterol: 5.66 ± 1.03 VS 4.92 ±1.07,t=4.654,P < 0.001;low density lipoprotein: 3.58 ±1.11 VS 2.89 ± 0.90,t=4.185,P < 0.001;uric acid:438.29 ± 73.86 VS 398.84 ± 83.45,t=3.395,P=0.001;fasting blood glucose: 7.61 ±1.96 VS 6.95 ±1.58,t=2.248,P= 0.025;systolic blood pressure: 145.07 ±11.37 VS 137.56 ±17.37,t=3.864,P < 0.001;homocysteine: 17.46 ± 8.42 VS 13.46 ± 7.20,t=3.173,P 0.002).There was no significant difference in triglyceride and diastolic blood pressure(P > 0.05).Follow up results of 489 subjectsIn 489 cases,34 cases of CAVI incomplete information were deleted.There were 455 subjects with a mean age of 65.2 + 11.8 years.Among them,261(57.4%)were male and 194(42.6%)were female.After 2.5 years of follow-up(median follow-up time of 27.3 months),a total of 24 subjects were newly diagnosed with ischemic stroke,and the cumulative incidence of stroke was 5.3%.After correcting age,gender,hypertension,diabetes,hyperlipidemia,hyperuricemia and hyperhomocysteinemia,the higher the CAVI value,the greater the risk of ischemic stroke(HR=2.21,95%CI =1.05-5.56,p=0.035).The risk of ischemic stroke in the high CAVI group was increased,2.23 times as high as that in the low CAVI group(HR=2.16,95%CI =1.09-5.91,p=0.041).After stratified by age found in people aged 65 years or older in the higher CAVI value,The greater the risk of ischemic stroke(HR=2.65,95%CI =1.23-5.49,p=0.019);The lower the CAVI value of people younger than 65 years old,the smaller the risk of ischemic stroke(HR=2.33,95%CI =1.12-5.26,p=0.021).It was found that the risk of CAVI and the risk of ischemic stroke were not related to sex(P > 0.05).2 CAVI,triglyceride,total cholesterol,low density,uric acid,fasting blood glucose,systolic blood pressure,diastolic blood pressure,homocysteine are compared of 78 cases of massive cerebral infarction and 284 cases of non large cerebral infarction,results showed that two groups of CAVI,triglyceride,total cholesterol,low density,uric acid,fasting blood glucose,systolic blood pressure,diastolic blood pressure and homocysteine had no significant difference(P > 0.05).3 Correlation analysis between CAVI patients and the risk factors of ischemic stroke in 362 cases,the results showed that CAVI was related to age,total cholesterol,low density,uric acid,fasting blood glucose,systolic blood pressure,homocysteine,the difference was statistically significant(P < 0.01).Except for triglycerides and diastolic blood pressure.The CAVI as the dependent variable,such as gender,age,triglyceride,total cholesterol,low density lipoprotein cholesterol,uric acid,fasting blood glucose,systolic blood pressure,diastolic blood pressure and homocysteine as independent variables,multivariate regression analysis,Stepwise method for variable selection criteria for 0.05,excluding standard 0.10.The results showed that 5 variables,including homocysteine,age,low-density lipoprotein,uric acid and fasting blood glucose,entered the equation in turn.R=0.998,R2=0.996,F=10359.609,P < 0.001.conclusions1.CAVI can be used as a predictor of ischemic stroke;the higher the CAVI value,the greater the risk of ischemic stroke.The risk of CAVI with ischemic stroke is associated with age,and is not related to sex.2.This study shows that it was not possible to predict the possibility of massive cerebral infarction or non massive cerebral infarction only from CAVI.3.CAVI was related to age,total cholesterol,low density lipoprotein,uric acid,fasting blood glucose,systolic blood pressure,homocysteine,and no significant correlation with triglyceride and diastolic blood pressure.ObjectiveTo observe the changes of CAVI,carotid ultrasound and head MRA before and after the anti atherosclerotic treatment of ischemic stroke patients,investigate the value of the cardio ankle vascular index in evaluating the effect of anti atherosclerotic treatment in patients with ischemic strokeMethods362 patients with ischemic stroke in our department were treated with anti atherosclerotic treatment for 1 years,the CAVI,blood lipid level,carotid artery intima thickness,Crouse score,and skull MRA were detected before and after the treatment.Before and after the treatment,252 cases of CAVI,blood lipid level and carotid artery color Doppler ultrasound examination were completed(122 cases of head MRA examination before and after the treatment),the differences of the indexes before and after the treatment were compared.to analyze the value of the cardio ankle vascular index in evaluating the effect of anti atherosclerotic treatment in patients with ischemic stroke.result1 The correlation between CAVI and CIMT,carotid artery plaque: In 252 cases,the thickness of the carotid artery was increased in 99 cases,and plaque in the carotid artery was found in 153 cases.there is positive correlation between CAVI and CIMT(r=0.434,P=0.02),The CAVI of patients with carotid plaques was higher than those without plaques [(11.89 + 2.54)and(11.03 + 2.17),P<0.05].2 Comparison of the indexes before and after treatment:Indexes of vascular risk factors:Comparison of each index of 252 patients before and after treatment,showed that cholesterol,triglyceride,low density lipoprotein cholesterol,uric acid,fasting blood glucose,blood pressure and homocysteine after the treatment was lower than that before treatment(total cholesterol: 5.17 ± 1.14 VS 4.19 ± 1.12,t=3.949,P < 0.001;triglyceride: 1.48 ±0.22 VS 1.20 ± 0.34.T=4.428,P < 0.001;low density lipoprotein: 3.52 ±1.06 VS 2.48 ± 0.94,t=4.741,P < 0.001;uric acid: 434.79 ± 64.10 VS 383.61 ± 60.78,t=3.755,P < 0.001;fasting blood glucose: 7.50 ± 1.70 VS6.39 ± 1.45,t=3.231,P,=0.002;systolic blood pressure: 146.10 ± 11.76 VS 133.69± 13.56,t=4.478,P < 0.001;diastolic blood pressure: 79.98 ± 10.99 VS 71.60 ± 6.38,t=4.276,P < 0.001;homocysteine: 17.69 ± 8.04 VS 12.29 ± 6.18,T=3.449,P,=0.001).CAVI,CIMT,Crouse integral and head MRA: the results showed that CAVI after treatment was lower than that before treatment(11.24 ± 2.45VS10.04 ± 2.19,t=2.379,P=0.020);CIMT and Crouse score had no significant difference before and after treatment(P > 0.05).122 patients underwent MRA examinationbefore and after treatment.113 patients showed abnormal changes in cerebral vascular structure before treatment,with an abnormal detection rate of 92.6%.The main manifestations are the interruption of the main artery and its main branches,Undeveloped of distal artery,the wide or limited narrowing,the branch reduction and so on.110 patients showed abnormal changes in cerebral vascular structure after treatment,The abnormal detection rate was 90.2%.There was no significant difference in the abnormal detection rate before and after treatment(?2=0.102,P=0.891).Conclusions1 There is a positive correlation between CAVI and CIMT,The CAVI of patients with carotid plaques was higher than those without plaques.This indicates that CAVI has a good correlation with carotid atherosclerosis and can be used as an indicator for evaluating the degree of atherosclerosis.2 The cardio ankle vascular index decreased after the treatment of anti arterioscleros,However,there were no significant changes in CIMT,Crouse integral and head MRA treatment,suggesting that CAVI can be used as a good monitoring index for the effect of anti atherosclerotic therapy. |
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