Analysis Of The Distribution, Association And The Risk Factors Of Intracranial And Extracranial Atherosclerosis In Patients With Ischemic Cerebralvascular Diseases

Objective:To realize the distribution of intracranial and extracranial arteriostenosis in patients with ischemic cerebral vascular disease (ICVD), to explore the risk factors of intracranial and extracranial atherosclerosis of ICVD, and to analyze the association between intracranial and extracranial atherosclerosis.Methods:293patients of ICVD were examined by MRA to learn about the state of artery stenosis inside of skull and by Carotid Artery Color Doppler Ultrasound(CACDU) to learn about the common carotid artery intima-media thickness(CCA-IMT)、properties of plaques. According to the results of MRA and CACDU, these cases were divided into three case groups and a normal group. Case groups were respectively as follow:I group, extracranial carotid atherosclerosis; Ⅱ group, intracranial arteriostenosis; Ⅲ, intracranial and extracranial atherosclerosis. We measured biochemical indicators such as TG, TC, LDLC, HDLC, and collected risk factors from case retrieval such as sex, age, smoking, drinking, diabetes mellitus and hypertension.Results:(1) There were264cases existing atherosclerosis in293patients by MRA and CACDU. Carotid atherosclerosis had45cases(15%), intracranial arteriostenosis58cases(20%), intracranial and extracranial atherosclerosis161cases(55%);(2) In the264patients, anterior circulation atherosclerosis had191cases(72%), posterior circulation atherosclerosis had47cases(18%), anterior and posterior circulation atherosclerosis had26cases(10%).(3) Single artery stenosis had97cases(37%), multiple artery stenosis167cases(63%).(4) Extracranial carotid atherosclerosis group:Logistic regression analysis results showed that the risk factors were male(OR=1.066), age(OR=0.239), diabetes mellitus(OR=7.960),hypertension(OR=7.876). Intracranial arteriostenosis group:the risk factors were diabetes mellitus (OR=9.069), hypertension (OR=8.166). Intracranial and extracranial atherosclerosis group:the risk factors were age(OR=:1.118), smoking(OR=13.531), diabetes mellitus(OR=3.624), hypertension (OR=8.164).(5) The associations between CCA-IMT、properties of plaques and the degree of MCA stenosis were not statistically significant. The associations between CPS and the number of intracranial vascular narrow were positive correlation (Rs=0.233, P<0.05)Conclusions:In this study, the rate of both extracranial and intracranial atherosclerosis was the highest, and anterior circulation stenosis or occlusion was more frequency than posterior circulation, and MCA was much easier vulnerable; Different risk factors existing between intracranial and extracranial arteriostenosis, the risk factors of carotid atherosclerosis were male, age, diabetes mellitus, hypertension; the risk factors of intracranial arteriostenosis were diabetes mellitus, hypertension; the risk factors of intracranial and extracranial atherosclerosis were age, smoking, diabetes mellitus, hypertension. The association between intracranial artery stenosis and extracranial carotid atherosclerosis was not significant. The associations between CPS and the number of intracranial vascular narrow were positive correlation.