The Effect Of Acute Cerebral Infarction Patients With Oxfordshire Community Stroke Study Divided Into Type And Common Carotid Artery

Objective: To study the effect of acute cerebral infarction patients with Oxfordshire Community Stroke Study(Oxfordshire Community Stroke Project,OCSP)divided into type and common carotid artery,internal carotid artery color Doppler ultrasound and cerebral artery TCD examination results of correlation,by detecting the comparison of acute cerebral infarction OCSP classification in patients with carotid artery color Doppler ultrasound and cerebral artery TCD examination data.To explore the clinical significance of carotid artery ultrasound and TCD examination of the middle cerebral artery in patients with cerebral infarction OCSP classification,in order to provide more effective information for the diagnosis,treatment and prognosis of acute cerebral infarction.Methods: 125 cases of Second Hospital of Shijiazhuang City in March 2012 March 2015 hospitalized patients with acute cerebral infarction,all patients are in line with clinical diagnostic criteria of acute cerebral infarction and by more than two chief physician diagnosis was confirmed by imaging,patients with complete data.The 125 subjects according to OCSP divided into standard type grouping,were labeled as TACI(totalante-riorcirculationinfarct)group,PACI(partialante-riorcirculationinfarct)group,POCI(posteriorcirculationinfarct)group,LACI(1acunarinfarct)group,and select 30 cases of healthy people as control group,5 groups of subjects in terms of age,gender,etc.do not exist significant difference(P>0.05),not statistically significant.By carotid artery ultrasound measuring diameter of carotid arteries in 5 groups of subjects,film thickness,plaque size,pay attention to the location of the plaque,echo characteristics and plaque morphology,size,nature,the middle cerebral artery by transcranial Doppler(TCD)collected 5 groups of subjects suffering from the side of the middle cerebral artery,get the direction of blood flow,blood flow velocity,spectral shape and pulsatility index parameters,and according to the classification of stenosis degree.All data are processed by SPSS12.0 statistical software package.Consistency analysis using Kappa value calculation,rank correlation analysis using H test,P<0.05 has statistical significance.Among them,32 cases of TACI group,31 cases in PACI group,30 cases in POCI group and 32 cases in LACI group.Results:1 Comparison of 5 groups of subjects of sex,age,course of disease,basic disease,clinical symptoms and other general information,TACI group of 16 cases were male,16 females,mean age(51.27±2.89)years old,the average duration of(3.28±0.27)years;group PACI 19 cases were male,12 females,average age(50.17±2.42)years old,the average duration of(3.10±1.19)years;group POCI 18 cases were male,12 females,mean age(52.18±2.20)years old,the average duration of(2.97±1.28)years;group LACI 19 cases were male,13 were female,the average age(55.29±2.14)years old,the average duration of(3.06±0.82)years;control group,18 cases were male,12 females,mean age(50.26+2.83)years;5 groups were no significant difference in gender,age(P>0.05),not statistically significant,the 4 groups of patients with acute cerebral infarction in patients There are no significant differences on the process(P>0.05),was not statistically significant;19 cases in group TACI 7 cases of hypertension,diabetes,hyperlipidemia in 18 cases,6 cases of cardiac heart disease;group PACI,17 cases of hypertension,5 cases of diabetes,high blood lipids in 14 cases,4 cases of cardiac heart disease;POCI group 21 cases of hypertension,7 cases of diabetes,16 cases of hyperlipidemia,3 cases of cardiac heart disease;group LACI,22 cases of hypertension,3 cases of diabetes,20 cases of hyperlipidemia,3 cases of cardiac heart disease;control group subjects without hypertension,diabetes,hyperlipidemia and other diseases;a few patients at the onset of acute cerebral infarction before the emergence of dizziness,nausea,vomiting and other transient ischemic symptoms,4 groups of patients with acute cerebral infarction and the clinical manifestations of carotid artery system in different degree(or)symptoms and signs and the mouth of the vertebrobasilar system paralysis,hemiplegia symptoms,4 groups There were significant differences in basic and clinical symptoms in patients with acute cerebral infarction(P < 0.05),which was statistically significant.2 the results of carotid ultrasound showed that the TACI group of carotid artery occlusion in 6 cases,2 cases of carotid artery stenosis,70% carotid artery stenosis,5 cases of > 50%,the detection of carotid atherosclerotic plaque in 27 cases,84 plaques detected 16 cases of more than four and the average plaque,plaque(3.01±1.25);PACI group the occlusion of the carotid artery in 3 cases of carotid artery stenosis,2 cases of carotid artery stenosis in 70%,more than 50% in 4 cases,the detection of carotid atheromatous plaque in 25 cases,there were 77 patches,four or more plaque in 18 cases,the average patch(3.15±1.01);Pock group of carotid artery occlusion in 0 cases of carotid artery stenosis.70% of 1 cases of carotid artery stenosis,50%3 cases,detection of carotid atheromatous plaque in 15 cases,28 plaques detected 5 cases of more than four and the average plaque,plaque(1.95±1.35);LACI group of carotid artery occlusion in 0 cases of carotid artery stenosis,1 cases of > 70%,> 50% in 2 cases of carotid artery stenosis the detection of carotid.There were 20 cases of atherosclerotic plaques,41 plaques were detected,four cases were 8 and above,the average plaque was(2.10±1.37).4 groups of patients with acute cerebral infarction carotid stenosis,plaque size,attention to the location of the patch,echo characteristics and the shape of the plaque,the nature of the significant difference(P < 0.05),with statistical significance.3 of the 5 groups of subjects of middle cerebral artery stenosis and TCD data classification,TACI group of normal blood flow in 3 cases,5 cases of slightly increased,increased moderately in 8 cases,16 cases of slow blood flow in the brain,arterial systolic blood flow speed(59.14 + 7.28),diastole blood flow speed(28.17 + 6.36),average speed(40.02±2.17),pulsatility index(0.74±0.18),resistance index(0.52 + 0.08);1 cases of normal group PACI blood flow,increased slightly in 14 cases,moderate in 12 cases,4 cases of slow blood flow in the brain,arterial systolic blood flow speed(65.23±12.03),diastole blood flow speed(30.26±9.20)and the average speed(45.28 + 10.28),pulsatility index(0.78 + 0.13),resistance index(0.54±0.07);Pock blood group of 14 normal cases,6 cases of slightly increased,increased moderately in 8 cases,2 cases of slow blood flow in the brain,arterial systolic blood flow speed(95.16 + 15.27),diastole blood flow speed(43.94 + 6.58),average speed(64.39±10.82),pulsatility index(0.82±0.19),resistance index(0.54±0.03);LACI blood group of 6 normal cases,13 cases of slightly increased,increased moderately in 5 cases,8 cases of slow blood flow in the brain,arterial blood flow peak velocity(85.64±12.94)and the end diastolic velocity(37.72±9.20),average speed(53.25±11.52),pulsatility index(0.89±0.15),resistance index(0.54±0.023);the 4 groups of patients with acute cerebral infarction patients with middle cerebral artery,there was a significant difference between the obtained flow direction,flow velocity,pulsatility index and other parameters(P<0.05),with statistical significance,the resistance index of the 4 groups of patients had no significant difference(P > 0.05),was not statistically significant.Analysis of arterial TCD examination the relationship between carotid artery ultrasonography and brain in 4 OCSP patients in the TACI group,middle cerebral artery lesions in 14 cases,accounting for 43.75%,extracranial internal carotid artery lesions in 17 cases,accounted for 53.12% of the intracranial vertebral artery and basilar artery in 4 cases,accounting for 12.50% of the cervical artery,extracranial lesions in 7 cases 21.88%;PACI group,middle cerebral artery lesions in 11 cases,accounting for 35.48%,extracranial internal carotid artery lesions in 9 cases,accounted for 29.03% of the intracranial vertebral artery and basilar artery in 3 cases,accounting for 9.68% of the cervical artery,extracranial lesions in 4 cases,accounting for 12.90% of the Pock group;middle cerebral artery lesions in 9 cases,accounting for 30%,extracranial internal carotid artery lesions in 7 cases,accounted for 23.33% of the intracranial vertebral artery and basilar artery in 13 cases,accounting for 43.33% of the cervical artery,extracranial lesions in 5 cases,accounting for 16.67% of the LACI group;middle cerebral artery lesions in 8 cases,accounting for 25%,extracranial internal carotid artery Some lesions in 8 cases,accounted for 25% of the intracranial vertebral artery and basilar artery in 5 cases,accounting for 15.63% of the cervical artery,extracranial lesions in 0 cases,accounting for 0%.There is a significant difference between the 4 groups of carotid artery and cerebral artery lesions in patients with acute cerebral infarction(P<0.05),with statistical significance.Conclusions:1 Diabetes,high blood lipids,hypertension,cardiac heart disease is the main risk factors of acute cerebral infarction,TACI patients are caused by cardiogenic embolism,OCSP type in patients with cerebral infarction lesions,vascular occlusion,the lesion size with high consistency.2 TACI and PACI type of acute cerebral infarction in patients with carotid artery vascular occlusion and severe stenosis rate was significantly higher than that of LACI and pock,acute cerebral infarction patients with carotid artery atherosclerotic plaque and OCSP type correlation exists,a higher rate of TACI and PACI patients of unstable plaque and plaque can be used as reference for the clinical diagnosis.3 TACI and PACI type of patients with acute cerebral infarction occurred in middle cerebral artery vascular lesions,pock patients for intracranial segment of vertebral artery and basilar artery lesions,LACI type patients is internal carotid artery extracranial vessels now lesions are more common.4 carotid artery color Doppler ultrasound and the middle cerebral artery TCD examination results and acute cerebral infarction OCSP classification of correlation and regularity.It can reflect the influence degree of carotid artery and middle cerebral artery disease on OCSP,and provide valuable reference for clinical work.