Prognosis Of Progressive Cerebral Infarction Of Different OCSP And Its Correlation With The Stenosis In Anterior Circulation Cerebral Artery

Objectives 1 To explore the relationships between subtypesof different OCSP of progressive cerebral infarction in anterior circulation and the stenotic in ICA and MCA,and carotid plaque, microembolism,and collateral circulation.2 To explore the prognosis of different subtyeps of OCSP of progressive cerebralin farction in anterior circulation.Methods 1 Patients researched Four hundreds and forty-sixth eligible patients with ischemic stroke were selected in department of Neurology Kailuan General Hospital from December 2013 to December 2014. 2 Grouping methods Accroding to the change of patients after admission, all the patients researched were divided into two groups, the group of PCI(n=90) and the group of non-PCI(n=356).According to the condition of admission and OCSP classification,each group were divided into three chinical subgroups, TACI, PACI and LACI. 3 Methods of research ①The informations of all the patients who selected were recorded,such as age,sex, hypertension, dysglycemia, lipid abnormality, smoking history, drinking history, cerebral stroke, heart disease.② All the patients had done TCD、C DFI to realize the condition of stenosis of ICA and MCA, carotid plaque, microembolism,and collateral circulation in the focus side and the contralateral. The condition of stenosis of ICA and MCA, carotid plaque, microembolism, and collateral circulation in the foc us and the contralateral sides between the PCI and non-PCI of TACI,PACI and LACI. Independent risk factors of PCI were found out by using the method of logistic regression. All the selected patients should be follow-up visited at 1 month from onset, then be evaluated about the short-term prognosis.Results 1 446 patients with acute cerebral infarction were included in the study.Among the 146 patients, 90 patients had PCI and 256 patients had non-PCI. There were not statistically significant differences abo ut the distribution in the two groups in age,sex,and other risk factors(P>0.05). 2 Among all the patients,the constituent ratio of PCI was 20.2%. The constituent ratio of PCI in every subtype was PACI>LACI>TACI. 3 In PACI, there were statistically significant differences in moderate stenosis of ICA, MCA, and ICA+MCA in the focus side, moderate stenosis of ICA, ICA+MC A in the contralateral side, microembolism of MCA in the focus side(P<0.05),between the two groups.There was a very significant difference in microembolism of MCA in the contralateral side(P<0.01),between the two groups. 4 In TACI, there were statistically significant differences in severe stenosis or occlusion of MCA and IC A+MCA in the focus side, severe stenosis or occlusion of ICA, MCA in the contralatera l side, between the two groups.There was a very significant difference in collateral circulation(P<0.01), between the two groups. 5 In LACI, there were statistically significant differences in microembolism of MC A in both the focus and contralateral side(P<0.01),between the two groups. 6 By using the method of logistic regression, we found out t hat the independent risk factors about PCI in anterior circulation were unstable plaque in both the focus and contralateral carotid artery, plaque in the contralatera l carotid artery, microembolismof MCA in both the focus and contralateral side(P<0.05). 7 In comparison with the 90 day MRS, the ratio of the disabled was higher than the other groups.Conclusions 1 The constituent ratio of PCI in every subtype of OCSP was TACI>LCAI>PACI. 2 In PACI, it was easier to lead to PCI when moderate stenosis of ICA, MCA, and ICA+MC A in the focus side, moderate stenosis of ICA, ICA+MCA in the contralateral side, microembolism of MCA in the both sides. In TACI, it was easier to lead to PCI when severe stenosis or occlusion of MCA and ICA+MCA in the focus side, severe stenosis or occlusion of IC A, MC A in the contralateral side and less collateral circulation. In LACI, it was easier to lead to PCI when microembolism of MCA in both the sides. 3 The independent risk factors about PCI in anterior circulation were unstable plaque in both the focus and contralateral carotid artery, plaque in the contralateral carotid artery, microembolism of MC A in both the focus and contralateral side. 4 In the three subtypes of OCSP, the short-term prognosis of TACI was the worst.