Analysis Of Clinical Risk Factors And Prognosis Of Asymptomatic And Symptomatic M1 Middle Cerebral Artery Occlusion

Objective:To investigate the prognosis and related risk factors of asymptomatic middle cerebral artery M1 occlusion(M1CAO)cerebral infarction and symptomatic middle cerebral artery M1 segment occlusion(M1CAO)cerebral infarction survivors.Methods:This study collected the diagnosis of head and neck CT angiography(CTA)or magnetic resonance angiography(MRA)from the first affiliated hospital of Nanchang University from January 2013 to January 2017.There were 357 confirmed cases of M1 segment occlusion(M1CAO)in the middle cerebral artery.According to exclusion criteria(1)Patients who die within one month of M1 segment occlusion of the middle cerebral artery.(2)Patients treated with endovascular treatment of blood vessels.(3)Patients with severe liver and kidney function impairment or intracranial tumors.(4)Major trauma,infection,history of surgery within 3 months.(5)Ipsilateral internal carotid artery occlusion or stenosis.324 cases were eventually included for clinical retrospective studies.According to the clinical manifestations and cranial imaging examination,the patients were divided into asymptomatic M1 CAO cerebral infarction group and symptomatic M1 CAO cerebral infarction group.Record the patient's age,gender,past history(including hypertension(HT),diabetes(Diabetesmellitus,DM),history of atrial fibrillation),personal history(including smoking history,drinking history),neurological signs after admission,US National National Institutes of Health Stroke Scale(NIHSS),Cholesterin(CHOL),Triglycerides(TG),Low density lipoprotein cholestero(LDL-C),High-density lipoprotein High Density Lipoprotein Cholesterol(HDL-L),homocysteine(Hcy),albumin,and cervical vascular ultrasound,etc.The risk factors and the prognosis of the end-point events were compared and analyzed in each group.Result:(1)A total of 357 cases were collected,Nine cases deaths accounted for2.52% within one month.Surgical treatment in 7 cases accounted for 2%.In the remaining Of the remaining 341 cases,17 cases accounted for 4.76% of the lost follow-up visits.Finally,324 cases were included in the study,There were 215 males(66.4 %)and 109 females(33.6%).They were divided into symptomatic M1 CAO cerebral infarction group and asymptomatic M1 CAO cerebral infarction group,with recurrence of stroke or death as the outcome event.Follow-up time was 3 to 56months(average follow-up time 27.5 months).Among the 271 patients with symptomatic M1 CAO,Eighty-five patients(31.4%)had an outcome,of which Among them,52 patients(19.2%)had recurrent stroke,Thirty-three(12.2%)patients died,In the asymptomatic M1 CAO group of the 53 patients,and 14(26.4%)patients had an outcome.There were 11 cases(20.8%)of recurrent strokes and 3 cases(5.7%)of deaths.(2)Statistical analysis of the asymptomatic group gender,age,history of hypertension,history of diabetes,personal history of stroke,atrial fibrillation,carotid artery disease,TG,TC,LDL,HDL,Hey,albumin,no statistically significant difference(P > 0.05),with other intracranial vascular stenosis and the number of counts was statistically significant(P < 0.05).There was no statistically significant difference in hypertensive history,diabetic history,personal history of stroke,atrial fibrillation,carotid artery disease,TG,TC,LDL,HDL,Hey,and albumin in the symptomatic group(P > 0.05).There was a significant difference in age and other stenosis and counts of intracranial vessels(P < 0.05).Univariate and multivariate Cox regression analysis showed that the degree of stenosis with other intracranial vessels and the number of stenosis were related to asymptomatic middle cerebral artery occlusion M1 cerebral infarction,and the degree of intracranial vascular stenosis was more obvious(OR=5.657,95% CI: 0.689 to 10.248,P=0.046).The number and degree of stenosis associated with other vessels and age were related to the prognosis of M1 segment occlusion of the middle cerebral artery in the symptomatic group,and the intracranial vascular stenosis was greater than 2 or more(OR=3.155,95% CI:1.259 to 7.906,P=0.029).Conclusion:1.The independent risk factors affecting the prognosis of symptomatic M1 segmental occlusion of middle cerebral artery occlusion are age and other vascular stenosis and degree.2.The independent risk factors affecting the asymptomatic middle cerebral artery segment M1 are the number and degree of stenosis associated with other vessels.3.The long-term prognosis of symptomatic middle cerebral artery occlusion M1 segment was worse than that of asymptomatic middle cerebral artery segment M1.