Factors Influencing Craniocerebral Angiostenosis And Clinical Values Of TCD In Detecting Angiostenosis

BackgroundTranscranial doppler is an non-invasively technology for examing the cerebral circulation dynamics at bedside ,which is convenient,fast and reduplicative.But the reliability of TCD in detecting angiostenosis is not definite. In addition, risk factors of craniocerebral angiostenosis has not been clear.And risk factors may be diffrent between intra-cranial and extra-cranial arteries.ObjectiveTo investigate the clinical values of TCD in detecting craniocerebral angiostenosis in comparison with DSA and to study the independent risk factors of craniocerebral angiostenosis.MethodA total of 73 cases was included,and we retrospectively reviewed clinical factors such as age, gender, smoking and drinking history and laborary results including total cholesterol, low density lipoprotein, hige density lipoprotein, fibrinogen,C-reactive protein, glycosylated hemoglobin,we also record the results of DSA,caroid ultrasound and TCD.cases was divided into non-stenosis group and stenosis group according to DSA, stenosis group was divided into single-vascular stenosis group and multiple- vascular stenosis group.The statistic difference was investigated among all the groups,and the independent risk factors that might influencing craniocerebral angiostenosis were studied through logistic analysis.ResultsTaking DSA as the gold standard,the sensitivity, specificity, positive predictive value and negative predictive value of TCD was 65.71%, 75.68%, 71.88%, 70.00% respectively.There is higher sensitivity in middle and severe vascular steonosis .The disparity of age, HDL,CRP,CIMT,PI,RI has significant difference on the effects of vascular steonosis when comparing non-stenosis group and stenosis group. total cholesterol, low density lipoprotein,CRP, apoproteinB is significantly different between single- angiostenosis and multi- angiostenosis.Results revealed that factors attributing to intra-cranial and extra-cranial angiostenosis maybe different.age, C reactive protein, apoprotein-A, carotid atherosclerotic plaque,hypertension, diabetes mellitus are independent risk factors of craniocerebral angiostenosis while age,smoking, C reactive protein of carotid atherosclerosis by logistic analysis. ConclusionTCD can be an important way for craniocerebral angiostenosis Screening . age, CRP, apoprotein-A1, carotid atherosclerotic plaque,hypertension and diabetes mellitus are independent risk factors of craniocerebral angiostenosis,While carotid atherosclerosis relevants to age,smoking, CRP.There may be different risk factors between intra-cranial and extra-cranial angiostenosis.