The Study Of Pathogenesis And Etiology For The Patient With Ischemic Stroke Accompanying Artery Stenosis

PARTⅠPURPOSE: To study the occurrence of intracranial and extracranial artery stenosisand etiological factor in the patient with ischemic stroke accompanying arterystenosis.METHODS: Ischemic stroke patients were detected TCD and MRA or DSA tounderstand intracranial and extracranial artery stenosis or occlusion . Then thecorrelation between artery stenosis and atherosclerosis hypertension, diabetesmellitus, hyperlipidemia and so on were studied.RESULTS: It was found that 70.30％large-artery was stenotic or occlusive inischemic stroke patients, among of them, intracranial artery stenosis or occlusion is52.63％, and extracranial artery is 17.67％. Middle cerebral artery was mostfrequently involved (37.75％), followed by internal carotid artery. The most commonpathogenesis of large-artery occlusive disease is artherosclerosis, main risk factorsincluding hypertension, smoking, family history and diabetes mellitus. Among ofthem, diabetes mellitus and family history is independent risk factors (P＜0.05).CONCLUSIONS: ischemic stroke patients in Chinese have a high occurrence ofintracranial artery occlusive disease. The main pathogenesis isarteriosclerosis. Diabetes mellitus and family history are the most important riskfactor of the large artery disease. PARTⅡPURPOSE: HLA-DQA1 and HLA-DQB1 gene polymorphism has been associatedwith cerebral atherothrombosis but the relationship between HLA-DQA1 andHLA-QDB1 gene polymorphism and ischemic stroke with extracranial caroticstenosis remains unclear. The present study is to analyze the relationshipbetween HLA- DQA1 and HLA-QDB1 gene polymorphism and ischemicstroke with intracranial artery stenosis.METHODS: 15 ischemic stroke with intracranial artery stenosis patients, 49ischemic stroke without intracranial artery stenosis patients and 52 healthy controls inTianjin in North China were investigated for HLA- DQA1 and HLA-QDB1genotyping by polymerase chain reaction-sequence specific primers (PCR-SSP).RESULTS: Compared with ischemic stroke without intracranial artery stenosispatients and healthy controls, the frequency of DQA1 ~*0501 andDQB1~*0501 allele was higher in ischemic stroke with intracranial arterystenosis patients .The difference had statistical significance, P＜0.05. Comparedwith healthy controls, the frequencies of DQA1 ~*0301 and DQB1 ~*0301 allele inischemic stroke without intracranial artery stenosis patients were higher, thefrequencies of DQA1 ~*0103 and DQB1 ~*0601 allele in ischemic stroke patientswere lower.CONCLUSIONS: HLA-DQA1~*0501 and HLA-DQA1~*0501 allele is positivelyrelated to the genetic susceptibility of ischemic stroke with intracranial arterystenosis. DQA1~*0301 and DQB1~*0301 allele is positively related to ischemiccerebrovascular disease. DQA1~*0103 and DQB1 ~*0601 allele might be a protectingallele in the patients with ischemic cerebrovascular disease.