Comparison Of Distribution,Risk Factors And Therapeutic Effect Of Intracranial Or Extracranial Artery Stenosis In Patients With Acute Cerebral Infarction

Objective:In this study,we mainly discuss the differences between different arterial stenosis groups in patients with ACI.Methods:A total of 96 patients with ACI with intracranial or extracranial arterial stenosis were enrolled in Hebei general hospital from March to December,2017.According to the results of carotid artery ultrasound and MRA,all patients were divided into simple extracranial artery stenosis group,simple intracranial artery stenosis group and extracranial combined intracranial artery stenosis group.The demographic and clinical data were collected,and then compared the differences among the three groups.SPSS21.0 statistical software was used for statistical analysis,and P<0.05 was considered statistically significant.Results:1.Of all the patients in the group,there were 23 cases?23.9%?in the simple extracranial arterial stenosis group and 14 cases?14.6%?in the simple intracranial artery stenosis group?14.6%?,and 59 cases?61.5%?in the extracranial combined intracranial artery stenosis group.The general data and risk factors of the three groups were statistically analyzed.The mean age of the simple intracranial arterial stenosis group was significantly lower than that of the other two groups.In extracranial combined intracranial arterial stenosis group,the number of patients with history of diabetes was higher,and the fasting plasma glucose?FBG?,glycosylated hemoglobin?HbA1c?,total cholesterol?TC?,low density lipoprotein?LDL?and apolipoprotein B?ApoB?,and fibrinogen?Fib?were all higher with statistical significance?P<0.05?.2.Arterial stenosis was more common in extracranial internal carotid artery?EICA??7.78%?in simple extracranial artery stenosis group,posterior cerebral artery?PCA??6.01%?and middle cerebral artery?MCA??4.51%?in simple intracranial artery stenosis group,and EICA?8.56%??common carotid artery?CCA??8.29%??PCA?6.42%?and MCA?5.44%?in extracranial combined intracranial arterial stenosis group.The partial anterior circulation infarct?PACI?of the three groups was higher than the posterior circulation infarct?POCI??60.9%VS 39.1%;71.4%VS 28.6%;55.9%VS 44.1%?.And all three groups of patients with cerebral infarction were mostly seen in basal ganglia?20%?24%?18.35%?and frontal?25.7%?20%?16.5%?infarction,followed by parietal infarction?11.4%?16%?11.9%?.3.In this study,the treatment of ACI was found in three groups:single antiplatelet therapy?SAPT?,double antiplatelet therapy?DAPT?,intravenous thrombolysis?IVT?,and intra-arterial thrombectomy?IAT?.In all ACI patients enrolled in the group,the proportion of SAPT?42.7%?or DAPT?41.7%?was significantly higher than that of IVT?9.4%?or IAT?4.2%?.In patients with simple extracranial arterial stenosis group,DAPT?47.8%?was significantly higher than other treatment measures.In patients with simple intracranial arterial stenosis group,the SAPT was higher?57.1%?.And in patients with extracranial combined intracranial arterial stenosis group,the SAPT?47.5%?was slightly higher than DAPT?42.4%?.However,there was no significant difference for the treatment in the three groups?P>0.05?.The repeated measurement variance analysis of NIHSS of three groups of patients found that the time effect of the three groups was statistically significant?P<0.01?.Subsequently,the pairwise comparison showed that the NIHSS score was significantly improved after treatment for the overall patients with NIHSS_7d?P=0.03?.And NIHSS_14d4d in patients with simple extracranial arterial stenosis group and extracranial combined intracranial arterial stenosis group was different from NIHSS_0d?P<0.01?.Conclusion:1.The study shows that ACI patients have more extracranial combined intracranial arterial stenosis.2.ACI patients with simple intracranial arterial stenosis are younger,and patients with extracranial combined intracranial arterial stenosis are more likely to have diabetes or hypercholesterolemia or hyperfibrinogenemia.3.EICA,PCA and MCA are common sites of arterial stenosis in ACI patients with extracranial or intracranial arterial stenosis.4.Cerebral infarction in ACI patients is more commonly seen in the basal ganglia and frontal lobes of the anterior circulation vessels.5.The clinical treatment of ACI patients with extracranial or intracranial arterial stenosis is mainly antiplatelet drugs.6.Extracranial or intracranial arterial stenosis has no effect on the neurological deficit and recovery of ACI patients.And most ACI patients can begin to recover their neurological deficits within one week after treatment.