Mechanical Analysis Of Carotid Plaque In Patients With Hypertension And Cerebral Infarction

Objectives By using two-dimensional ultrasound to observe the predilection site and acoustic characteristics of carotid plaques of the hypertension patients with cerebral infarction(including the common carotid artery,carotid artery bifurcation,the internal carotid artery).Applying the technology of velocity vector imaging(VVI)to detect the mechanical change of the carotid plaque,and analyse the difference of these mechanical change for different stages,so we can findout the risk factors which decrease the stability of plaque,and early forecast the occurrence of cerebral infarction.Methods Selecting 98 patients have carotid plaques with hypertension and cerebral infarction as case group and 120 patients have carotid plaques with purely hypertention control group.All patients consulted in the North China University of Science and Technology affiliated hospital from 2015-7 to 2016-12.Collecting all patients' general information(gender,age,smoking or no,alcohol abuse or no,heart rate,blood pressure,blood lipid,fasting plasma glucose)and some relevant ultrasonic measurement parameters(whether the vascular intima and tunica media are smooth or not,with or without thickening and the pipe wall format plaque or no,and record the parts,the length and the maximum thickness,the number and the echo characteristics of plaque,whether the blood vessel is narrow or blocked in detail,VVI technology indicators).We check all data strictly,use Excel 2003 software to establish database,and apply SPSS 17.0 statistical software to analysis statistics.Results 1 General data analysis:For all patients in this study,In case group 98 patients,including 65 male and 33 female;In control group 120 patients,including 76 male and 44 female.Both groups of gender composition,age factor comparison,the smoke and drink,The heart rate,blood pressure,FPG,TC,TG,HDLC,LDLC value factors between two groups are analysed shows that there were no statistically significant difference(P>0.05).2 Ultrasound parameters of two group patients analysis:(1)The plaque detection situation analysis of patients in different course between control group and case group,in the Course of 10 years or less and course > 10 years,are the common carotid artery bifurcation plaque has the highest detection rate.(2)The stability comparison of low/middle and lower echo plaques and mixed echo plaque between the case group and control group,in which case group choose low/middle and lower echo plaques 50 cases,48 cases of mixed echo plaques,control group choose low/middle and lower echo plaques 38 cases,32 cases of mixed echo plaques,two groups of patients compared the distribution of the selected plaque,there was no statistically significant difference(P>0.05),and it is concluded that the selected plaques of the corresponding points in both groups between V,Smax,SRmax difference was statistically significant(P<0.05),suggesting the corresponding points compared case group with control group,fast blood flow velocity,high resilience,plaque stability is relatively poor.(3)Select 120 cases of mixed echo plaques and 128 cases of low/middle and lower echo plaques,comparison to its corresponding points,the Peak velocity of blood flow Of corresponding points in systolic,from near heart intima-media to telecentric intima-media,first reduce and then rise again,V · A>V · B>V · C>V · D<V · E,the difference was statistically significant(P<0.05);the Maximum strain carry a first rise then to reduce the rising again,Smax·A<Smax·B>Smax·C>Smax·D<Smax·E,the difference was statistically significant(P<0.05);the Maximum strain rate carry a first rise then to reduce then rising again,SRmax·A<SRmax·B>SRmax·C>SRmax·D<SRmax·E,the difference was statistically significant(P < 0.05).the speed of blood flow faster near the heart,plaques near heart side shoulder had the fsater blood flow speed and higher resilience than other parts,stability is worse.(4)To analyze risk factors on whether cerebral infarction occurred,In the general information,Low density lipoprotein cholesterol(hdl-c),Blood sugar,are risk factors for cerebral infarctionoccurred,High density lipoprotein is the protective factor of cerebral infarction occurred.In VVI parameters,SRmax·C is the protective factors of cerebral infarction occurred,V·A,Smax·C,Smax · E,SRmax · A,SRmax · B,SRmax · E are risk factors for cerebral infarction occurred.Conclusions 1 The Plaque stability of patients with hypertension and cerebral infarction is lower than purely hypertension patients.2 The shoulder part of proximal end of carotid plaques have the lowest stability and is easy to be damaged.3 In the general information and VVI parameters,High density lipoprotein and SRmax·C are the protective factors of cerebral infarction occurred,including Low density lipoprotein cholesterol(hdl-c),Hyperglycemia,increased blood flow velocity and increase of strain rate at the proximal end of plaque,are risk factors for cerebral infarction.