The Clinical Reserach Of Using Combination Of ESRS, Angiography And TCM Syndrome To Predict Prgnosis Of Ischemic Cerebrovascular Disease

Objective:To find out the predictive methods for the recurrence of ischemic cerebral vascular disease(CVD), and other cardiovascular events within the patients with acute ischemic stroke/TIA.Methods:147 patients with acute ischemic cerebrovascular disease were given the following evualutions, including cerebral digital substrating angiography (DSA), Essen stroke risk score(ESRS) and TCM differention of stroke syndrome. Only those patients with cerebral stenosis confirmed by DSA, were selected and followed-up one year.The survial and stroke recurrence as well as cardiovascular events were investigated and analysed with clinical data such as the characteristics of DSA, ESRS and TCM syndrome by SPSS 17.0.Results:1.There were 21 patients had vasuclur events during one-year follow-up, which inclued 17 patients had recurrence of ichemic stroke,3 had ischmic cardiovacular events,1 died of recurrent ischemic stroke.The rate of ischemic stroke recurrence was 20.39%, recurrent rate of cardiovascular disease was 2.91%, totally 23.30%.2. The Relationship Between The Vascular Events And Cerebral Vascular Stenosis2.1.Location And Vascular EventsThe recurrent rate was 20.69%in who only had intracranial artery stenosis,7.50%in who only had extracranial artry stenosis,32.35%in those had both intracranial and extracranial artery stenosis. There was a significant difference in the three groups(P< 0.05). Pairwisely comparisoning, the recurrence rate in both intracranial and extracranial artery stenosis group was significant higher than that of the extracranial artry stenosis group (P<0.01),which suggesting that patients had both intracranial and extracranial artery stenosis are more likely to suffer from secondary cerebral vascular events.2.2.Number Of Abnormal Blood Vessels And Vascular EventsThe recurrence rate of vascurlar events in multi-vessel stenosis group was 29.63%, significantly higher than 8.16% that in one-vessel stenosis group(P<0.01).2.3.Degree Of Stenosis And Vascular EventsThe recurrence rate of vascular events was 23.38% in moderate-above degree stenosis and occlusion group,7.69% in mild stenosis group, unspectively, there was no significant difference between the two groups(P>0.05). 3.The Relationship Between The Vascular Events And ESRS103 patients were devided into two group,70 cases with high-risk group with ESRS≥3 and 33 cases with medium-risk group with ESRS<3. Recurrence rate in high-risk group was significantly higher than that in medium-risk group,25.71% vs 6.06%(P<0.05).4.The Relationship Between The Vascular Events And AgeThe aged group had a slight higher recurrence rate of vascular events(26.98%) than the middle-youth age patients(10.00%), indicating that Aged patients are at high risk of recurrence (P<0.05).5.The Relationship Between The Vascular Events And TCM DifferentionAll cases were divided into five groups:phlegm-heat and sthenia of fu-organ group, qi deficiency and blood stasis group and Yin-deficiency and wind generating group, wind-phlegm and blood stasis group, sudden excess of liver-yang group.Recurrence rate of five syndromes were 6.67%,17.24%,71.43%,19.57% and 0%, respectively. There were differences in first three syndromes(P<0.05), and Yin-deficiency and wind generating group had a higher recurrence rate than others(P<0.0125). Thus, recurrence is common in the patients with Yin-deficiency and wind generating syndrome.Conclusion:1.Fatal or non-fatal cardiovascular and cerebrovascular recurrence were higher in the ischemic cerebrovascular patients with artery stenosis It suggests that the secondary prevention for such patients is necessary.2.It has clinical significance and practical value to predict the recurrence of CVD and other cardiovascular disease events by using the combination of DSA, ESRS and TCM differention.