Pathogenesis And Possible Prognostic Factors Of Anterior Circulation Watershed Infarction

[Objective]According to the imaging type,patients were divided into anterior circulation trunk infarction and anterior circulation watershed infarction grou-p,Cortical Watershed Infarction and Internal watershed infarction group.According to Barthel score,patients with anterior circulation watershed infarctio-n were divided into groups with possible good prognosis and poor prognosi-s.By comparing the clinical data of the above groups,studying on the mec-hanism and prognostic risk factors of anterior circulation watershed infarctio-n.[Methods]The patients with acute cerebral infarction who were admitted to t-he First Affiliated Hospital of Fujian Medical University from December 2014 to December 2016 were retrospectively analyzed by MRI 3.0T included SWI sequence.According to the imaging type,there were 23 cases of anteri-or circulation trunk infarction,92 cases of anterior circulation watershed infarction,and 24 cases of cortical watershed infarction,68 cases of internal w-atershed infarction.According to Barthel score,patients with anterior circula-tion watershed infarction were divided into groups with possible good progn-osis and poor prognosis,and 30 cases of possible good prognosis,62 cases of possible poor prognosis.The anterior circulation trunk infarction and anter-ior circulation watershed infarction group,cortical watershed infarction and i-nternal watershed infarction group,possible good prognosis and poor progno-sis group,above each group data such as hypertension,diabetes and atrial fibrillation history,biochemical indexes such as hemoglobin,fibrinogen,TG,H-b A1 C,D-dimer,Hcy,LDL-C etc.,and imaging indexes such as bilateral car-otid artery intimamedia thickness,left atrial diameter,left ventricular ejection fraction,numbers of dot HSs,numbers of DMV will be compared.[Results]It was concluded that there were significant differences in D-dimerand NIHSS score between the two groups of the anterior circulation trunk infarction and anterior circulation watershed infarction(P<0.05),the others were not statistically significant(P>0.05),the D-dimer and the NIHSS score in anterior circulation trunk infarction were higher than those in the anterior circulation watershed infarction.By comparing the cortical watershed infarction and internal watershed infarction group,there were significant differences in Hcy,LDL-C,D-dimer,proportion of atrial fibrillation,number of dot HSs,number of DMV and prognosis(P<0.05),the others were not statistically sig-nificant(P>0.05),D-dimer,Hcy,proportion of atrial fibrillation in cortical wa-tershed infarction were higher than those in Internal watershed infarction,LDL-C,numbers of dot HSs,numbers of DMV and proportion of poor prognosi-s in Internal watershed infarction were higher than those in Cortical Watershed Infarction.It was concluded that there were significant differences in NI-HSS score,numbers of DMV,Hcy between the two groups of possible goo-d prognosis and poor prognosis,the other were not statistically significant(P >0.05).Multivariate Logistic regression found analysis in prognosis group showed that NIHSS>3points,the number of DMV>5,Hcy>12umol/L were t-he risk factors of prognosis in anterior circulation watershed infarction.[Conclusion]This study suggests that CWSI was prone to embolic events.Hemodynamic disorders may lead to Internal watershed infarction.NIHSS>3poi-nts.The number of DMV>5,Hcy>12umol/L were the risk factors of progno-sis in anterior circulation watershed infarction.