| Objective:With the rapid development of economy and population aging,the incidence of the cerebrovascular disease rate increased significantly,and patients suffered from cerebrovascular disease became younger and younger.Transient ischemic attack(TIA)is a common neurological disease,it's mortality and disability are very high,and lots of the patients progressed to cerebral infarction.It seriously affect the quality of life of patients and the ability to work,not only bring the psychological and the economic burden to the patients and their families,but also to cause a huge impact on society.It is particularly necessary to investigate the etiology of transient ischemic attack.TIA can be usually divided into carotid artery system TIA and vertebrobasilar system TIA.The clinical symptoms include limb weakness,numbness,transient dizziness,language barrier,black haze,dysphagia,drop attacks.Carotid artery intima-media thickness,plaque formation and stenosis is an important cause of ischemic cerebrovascular disease.Only to improve the detection rate of carotid artery stenosis in patients with transient cerebral ischemic attack,in order to understand the relationship between carotid artery disease and clinical symptoms,so as to effectively prevent the occurrence of transient ischemic attack,reduce the global social and economic burden.The purpose of this study is to investigate the pathological characteristics of the patients with cervical artery transient ischemic attack,and the relationship between TIA and carotid artery disease.For the diagnosis of TIA,reduce the incidence of TIA,this study has important clinical significance.Methods: From January 2014 to January 2016 in Hebei Province People's Hospital of and the second hospital of Zhangjiakou city,a total of 100 patients diagnosed TIA continuously were collected as the TIA group,a total of 69 healthy people who performed physical examination in the above two hospital physical examination center were collected as control group.Age,gender and other general information had no significant difference betweed two groups.All patients underwent MRI,blood pressure,electrocardiogram,blood glucose,blood lipids and so on.Blood flow velocity,lumen diameter of arteries,plaque location,plaque shape,plaque size and its nature,artery stenosis or not were measureed and observed in all subjests at common carotid artery,carotid artery bifurcation,extracranial internal carotid artery,extracranial vertebral artery and bilateral subclavian artery.Ultrasonic diagnosis standard:(1)two bit image display hard plaque echo,rear with acoustic shadow,(2)two bit image soft spot shows low echo or medium-low echo,(3)image display for mixed plaque echo was uneven,the former is stable plaque,the latter two are unstable plaques.The calculation formula of the degree of luminal stenosis: the vascular stenosis rate =(1-minimum residual lumen / distal normal primary lumen diameter)x 100%.If the same intravascular multiple plaque or stenosis,stenosis only the most serious parts analysis the degree of luminal stenosis.The degree of stenosis was classified according to the following criteria:(1)mild stenosis: from 0 to 49%,(2)moderate stenosis: 50% ~ 69%,(3)severe stenosis: 70 ~ 99%,(4)total occlusion: 100%.Results:1 The incidence of hypertension,hyperlipidemia,diabetes,high blood glucose,smoking,obesity rate of the TIA group was higher than those of the control group,the difference was statistically significant(P < 0.05).2 The total cholesterol,low density lipoprotein cholesterol and fasting blood glucose levels of the TIA group were higher than those of the control group,high cholesterol water is lower than the control group,there was significant difference between two groups(P < 0.05),triglyceride content between the TIA group and the control group had no significant difference(P > 0.05).3 The plaque detection rate of the TIA group was 80%.68 TIA patients had vulnerable plaque were detected,the detection rate was 68%.The plaque detection rate the control group was 36.2%,12 healthy people had vulnerable plaque were detected,the detection rate was 17.5%.The incidence of plaque detection rate and vulnerable plaque detection rate at the TIA group were higher than those of the control group,the differences were statistically significant(P < 0.05).4 The TIA group is prone to grow soft plaque plaque,accounted for 62.2%,compared with 16.7% in the control group,the difference was statistically significant(P < 0.01).The ratio of multiple hard plaque at the control group was 66.7%,compared with 25.9% of the TIA group,the difference was statistically significant(P < 0.05).5 Carotid atherosclerosis occurs always in the common carotid artery bifurcation.The incidence of plaque in the common carotid artery bifurcation had no significant difference(P > 0.05)at vertebral basilar artery system TIA subgroup,internal carotid artery system TIA group and control group.The incidence of subclavian artery plaque were lower at the internal carotid artery system TIA group compared with the vertebral basilar artery system TIA group,the difference was statistically significant(P<0.05).6 Those were increased significantly for unilateral vertebral artery vascular tortuosity,abnormal running,and the incidence of vertebral artery diameter narrowing,blood flow slowly,resistance index,pulsatility index of vertebral basilar artery system TIA group(P<0.01),compared with those of the control group and the carotid artery system TIA group.There was no significant difference between the carotid artery system TIA group and the control group(P > 0.05).Conclusion: Color doppler ultrasound is a reliable method for monitoring TIA patients with neck artery disease,and can be used as an important means of TIA screening.It has important significance of color doppler ultrasound using to prevent the occurrence of TIA,and in diagnosis and treatment of TIA. |
PDF Full Text Request