Analysis Of The Association Of Intracranial Cerebral Artery Stenosis With Neurological Dysfunction And The Risk Factors

Purpose: to investigate the influence of intracranial cerebral artery stenosis on acute neurologic impairment and its main risk factors,and to provide a reliable basis for the choice of therapeutic treatments, the judgment of prognoses and the effective preventive measure by making an MRA examination on patients suffering from ischemic cerebral vascular disease and analyzing the risk factors.Objects and methods: Objects were 100 patients with cerebral infarction, hospitalized in the department of neurology of the Second Hospital Affiliated to Nanchang University from 10/2008 to 10/2009, among whom 64 were male, 36 female, from 41-year-old to 84-year-old and the average age was 63.77±10.63. All the patients complied with the diagnostic standard stipulated in Diagnoses of Ischemic Cerebral Vascular Disease revised on the fourth National Conference on Cerebrovascular Disease and the possibility of cerebralhemorrhage had been excluded, which was confirmed by CT and MRI. All the uncontrollable factors (gender, age) and controllable factors (hypertension, history of diabetes, blood-fat, etc.) were carefully inquired about on admission and neurological dysfunction was evaluated with American National Institute of Health Stroke Scale (NIHSS), 4ml blood drawn from a vein on a empty stomach in the morning to detect numerical values of blood sugar, total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein and so on. All the patients received magnetic resonance angiography (MRA) and according to the MRA results they were divided into two groups: one group with artery stenosis and the other without stenosis; the group with artery stenosis was further divided into two teams: one with multiple arterial stenosis and the other with single arterial stenosis. The two groups of data were compared statistically to make the differences between the NIHSS values and risk factors of the two groups.Results: Among the 100 patients, 55% (55 cases) were with intracranialcerebral artery stenosis and the other 45% (45 cases) were without. The results of NHISS evaluation and T examination showed that NIHSS was significantly increased in patients with intracranial arterial stenosis compared with those without stenosis (5.85±4.305 vs 3.24±2.288,P=0.0001; refer to table 1). Meanwhile, NIHSS was higher in patients with arterial stenosis in anterior cerebral circulation compared with those with stenosis in posterior cerebral circulation, though the difference was not significant (6.57±4.472 vs 4.38±3.583 P=0.227). NIHSS was also comparable in patients with either single or multiple intracranial cerebral arterial stenosis and the difference was not significant. 63.6% of the patients in the group with intracranial cerebral artery stenosis suffered from hypertension, 20% from diabetes. The means of age, blood sugar, total cholesterol, triglyceride and low-density lipoprotein were higher in patients with intracranial arterial stenosis compared with those without stenosis. In the single factor analysis, 11% of the patients (20 cases) in the group with artery stenosis suffered from diabetes, while in the group without stenosis 4.4% of the patients (2 cases) suffered from diabetes. The difference was significant (P=0.021; refer to table 2). In Logistic multifactor Forward Stepwise (Wald), blood sugar, triglyceride, cholesterol, high-density lipoprotein and low-density lipoprotein, diabetes, hypertension, gender and age served as independent variables, artery stenosis as the induced variable, to show the association of diabetes with intracranial cerebral artery stenosis (OR=5.375, P=0.035). The single factor analysis of the group with single intracranial cerebral arterial and the group with multiple intracranial cerebral arterial showed that 8% of the patients (2 cases) in the group with single intracranial cerebral arterial suffered from diabetes,while in the group with multiple intracranial cerebral arterial 30% of the patients (9 cases) suffered from diabetes. The difference was significant (P=0.042). The age of the group with single intracranial cerebral arterial was younger that that of the group with multiple intracranial cerebral arterial (61.36±10.15 years old vs 67.27±8.90 years old), and the difference was significant (P=0.026; refer to table 3). In Logistic multifactor Forward Stepwise (Wald), blood sugar, triglyceride, cholesterol, high-density lipoprotein and low-density lipoprotein, diabetes, hypertension, gender and age served as independent variables, artery stenosis as the induced variable, to show the association of age with multiple intracranial cerebral arterial (OR=4.632, P=0.031).Conclusion: 1. Neurological dysfunction is relatively more severe in patients with intracranial arterial stenosis and will affect prognoses. There is no difference in neurological dysfunction between arterial stenosis in anterior cerebral circulation compared with stenosis in posterior cerebral circulation.2. Diabetes is an independent risk factor for intracranial arterial stenosis. Both diabetes and old age are independent risk factors for multiple intracranial arterial stenosis, especially old age.