The Clinical Study Of Relationship Between Microembolism In Cerebral Blood Flow And Carotid Atherosclerotic Plaque During Patients With Acute Cerebral Infarction

Objective: To study the relationship between micro-emboli, carotid artery plaque and acute cerebral infarction by carotid ultrasound detection and transcranial Doppler micro embolic monitoring during patients with acute ischemic cerebrovascular disease.Methods: 67 hospitalized patients with acute ischemic stroke were found by the First Affiliated Hospital of ShanXi Medical University, which consisted to 56 males and 11 females, aged range from 34 to76 years, mean age 58±11 years. Firstly the patients were confirmed whether existed the infarct by CT or MRI detection, and recorded the infarct location. Secondly we recorded the number and location of emboli by TCD monitoring. Finally the patients were confirmed whether existed carotid artery plaque by the color Doppler ultrasound, and analyzed the plaque of location, number, echo-strength. With the statistical analysis we study the relationship between micro-emboli, carotid artery plaque and acute cerebral infarction.Results :67 hospitalized patients with acute ischemic stroke were found,of which there are 21 cases hypertension,5 cases diabetes mellitus,48 cases smoking,15cases hypercholesterolemia,14 cases hypertriglyceridemia,14 cases low high-density lipoprotein hyperlipidemia,7 cases high low-density lipoprotein hyperlipidemia. 67 patients were divided into carotid atherosclerotic plaque group (n=40) and without carotid atherosclerotic plaque group (n=27) according to the results of carotid artery ultrasound examination, the carotid artery atherosclerotic plaque group of high blood pressure,diabetes mellitus,smoking,hypercholesterolemia,high low-density lipoprotein hyperlipidemia compared with the without carotid atherosclerotic plaque group had significant differences, while the carotid artery atherosclerotic plaque group of age,hypertriglyceridemia and low high-density lipoprotein hyperlipidemia compared with the without carotid atherosclerotic plaque group was not statistically significant.67 patients were detected by TCD during 1～7d,there are 13cases that were detected out micro-emboli. there are 16 micro-embolus recorded, there are two micro-embolus in 3cases, there are one micro-embolus in 10 cases, the micro-embolus signal strength of 9～22dB, there are 6 cases detected micro-embolus in the left side middle cerebral artery, there are 4 cases detected micro-embolus in right middle cerebral artery, there are 3 cases detected micro-embolus in bilateral middle cerebral artery. There are 40 cases having the carotid atherosclerosis plaque in 67 cases, the incidence rate of carotid atherosclerosis plaque was 59.7%, there are 21 cases hard plaque, there are 19 cases soft plaque or mixed plaque. There are 9 cases having carotid atherosclerosis plaque in left carotid artery, there are 7 cases having carotid atherosclerosis plaque in right carotid artery, there are 24 cases having carotid atherosclerosis plaque in bilateral carotid artery. There are 16 cases single carotid atherosclerosis plaque and 24 cases multiple carotid atherosclerosis plaque.The micro-emboli positive rate of carotid plaque group compared with the non-plaque group had significant differences(χ~2 = 7.13, P < 0. 05); The micro-emboli positive rate of hypoechoic and mixechoic of plaque compared with the strong echo plaque was significantly(χ~2 = 5.20, P< 0. 05); The micro-emboli positive rate of single plaques group compared with the multiple plaque group showed no significant difference(χ~2= 0. 68, P > 0. 05).Conclusion:1,The patients with acute ischemic cerebrovascular disease most associated with carotid atherosclerosis, which are an important factor of stroke.2,The hypoechoic and mixechoic of plaque may be active instability plaque, which may easy shed emboli to induce cerebral infarction.3,The active instability plaque is one of the factors of cerebral infarction.