Analysis Of Brain MRA And Carotid Ultrasound Examination In Patients With Cerebral Infarction Associated With Human Cytomegalovirus Active Infection

Objective: Incidiency of cerebral infarction increases yearly. It is a difficult problem for clinical researchers to find the pathogeny or promoting factor of cerebral infarction and develop pertinent prevention and cure. Arteriosclerosis base on the major pathology of cerebral infarction. Hypertension﹑diabetes﹑blood lipid are mostly danger factors of cerebral infarction. Recently, Studies have shown that microbe infection, and what's more, the human cytomegalovirus(HCMV) infection may be associated with cerebral infarction. HCMV infection may improve thrombosis and plaque crack, then may be contributed to cerebral infection. Athersclerosis can be reflected by examination of brain magnetic resonance angiorgraphy (MRA) and carotid ultrasound. Analysis of brain MRA and carotid ultrasound examination in cerebral infarction patients actively infected by HCMV may contribute to exploring the relativity between HCMV and athersclerosis and cerebral infarction. This study apply the immunity fluorescence method to determine HCMV pp65 antigen in peripheral blood leukocytes,which is the index of HCMV active affection, to explore the characteristic of brain MRA and carotid ultrasound examination in cerebral infarction patients actively infected by HCMV. This study may provide a new image consult for clinical doctors to make diagnosis and give treatment.Methods: 31 patients with cerebral infarction actively infected by HCMV (actively infected group, whose HCMV pp65 antigenaemia examination is positive ) and 81 patients with Cerebral Infarction inactively infected by HCMV (inactively infected group, whose HCMV pp65 antigenaemia examination is negative) were included. Brain MRA were examined by all patients. Affected by patients'economic condition and private will, carotid ultrasound were examined by only 27 patients in actively infected group and 70 patients in inactively infected group. TIA﹑hypertension﹑diabetes﹑blood lipid﹑coronary heart disease﹑cerebral infarction history and family history were written down in detailed. history of past illness were graded. The result of brain MRA and carotid ultrasound examination were compared between two groups.Results: There were no significant difference of TIA﹑ hypertension﹑diabetes﹑blood lipid﹑coronary heart disease﹑cerebral infarction history﹑family history and grade of history of past illness between actively infected group and inactively infected group(P﹥0.05). Comparing brain MRA examination, There were no significant difference of normal﹑straitness﹑occlusion﹑arteriosclerosis and more than two pathological changes (12.90%﹑ 6.45%﹑ 6.45%﹑ 41.94%﹑ 38.71% vs. 7.41%﹑9.88%﹑3.7%﹑54.32%﹑23.46%, P﹥0.05). There were no significent difference of internal carotid artery system﹑vertebral-basilar artery system and all that be put into trouble(29.03%﹑3.22%﹑54.84% vs. 24.69%﹑1.23%﹑67.90%, P﹥0.05), Comparing carotid ultrasound examination, There were no significent difference of normal﹑thicked intima and plaque formation between two groups(14.81%﹑7.41%﹑77.78% vs. 8.57%﹑2.86%﹑88.57%, P﹥0.05). The number of plaque in actively infected group is 66, compared with 123 in inactively infected group. there wasn't difference in flat plaque﹑soft plaque﹑rigid plaque﹑mixed plaque between two groups ( 10.61%﹑ 33.33%﹑ 36.36%﹑ 19.70% vs. 13%﹑28.46%﹑45.53%﹑13.01%, P﹥0.05). There was difference in the number of plaque at ICA(X2=5.007,P=0.024).The ratio of instable plaque at ICA was significent difference between two groups (X2=6.190,P=0.013).Conclusions: (1)There was no significant difference of brain MRA examination between two groups; there was difference of the number of plaque at ICA between two groups; (2)There was significent difference of the number of instable plaque at ICA between two groups. Instable plaque at ICA may be associated with of HCMV active infection in patients with Cerebral Infarction. HCMV active infection may improve cerebral infarction by inducing plaque crack (3)HCMV active infection may be one of factors inducing cerebral infarction. Enlarging case'number and researching further was necessary.