Correlative Study Of Acute Cerebral Infarction With Vulnerability Of Carotid Atherosclerotic Plaque And H-hypertension

Objective:Carotid vulnerable plaque was an major pathological basis of cerebral infarction,hypertension and hyperhomocysteinemia were two independent risk factors for cerebral infarction.The correlativity between H-hypertension and the feature of atherosclerotic plaques had becomed a hot topics.This study primarily focused on discussing the correlation between vulnerable plaque of carotid atherosclerotic and H-hypertension in patients with acute brain infarction.Methods:230 patients of acute cerebral infarction in Xinzhou city people's Hospital were met the inclusion criteria,which were from December2014 to December 2016.According to the results of carotid artery color ultrasonic inspection,we separated the participants into two groups: vulnerable plaque group and non-vulnerable plaque group.The difference of plasma homocysteine and related indicators between the two groups were compared.According to the results of homocysteine and the history of hypertension,we divided all participants into four groups,H-hypertension group,hypertension group,HHcy group and normal group.The detection rate of vulnerable plaque of carotid artery in 4 subgroups was observed.Comparing the incidence of unstable plaque of carotid artery in H-hypertension group to the other three groups.The study further analyzed the interaction between homocysteine and hypertension in carotid vulnerable plaque development in patients which suffered from acute cerebral infarction.Results:1.The comparsion between vulnerable plaque group and non-vulnerable plaque group in general and laboratory index showed: There were obvious distinct between the two groups in terms of hypertension,homocysteine,CRP,LDL-C,HDL-C and ApoA,other risk factors(age,diabetes,smoking history,drinking history,TG,TC,ApoB,FIB)were not obvious difference.2.The carotid vulnerable plaque was as the dependent variable,and the obvious indicators of single factor analysis was as independent variable,carries on mulfactor logistic regression showed: hypertension,hyperhomocysteinemia,CRP,LDL-C were independennt dangerous factors for the development of carotid artery vulnerable plaques,HDL-C was protective factor for the development of carotid artery vulnerable plaques.3.The incidence of unstable plaque of carotid artery in four cases: H-hypertension group> hypertension group> HHcy group> normal group.4.Interaction analysis: hypertension and hyperhomocysteinemia played a synergistic role in the formation of carotid vulnerable plaques in patients with acute ischemic stroke(S=7>1),of which 63.2% of patients with acute cerebral infarction with carotid vulnerable plaque was caused by interaction of hypertension and hyperhomocysteinemia.Conclusion:1.Hypertension and hyperhomocysteinemia were closely related to the formation of carotid vulnerable plaque in patients with acute cerebral infarction.2.H-hypertension was more likely to lead to the occurrence of carotid vulnerable plaque,hypertension and hyperhomocysteinemia played a synergistic role in the development of carotid vulnerable plaques in patients with acute cerebral infarction.