The Clinical Significane Of Cerebral Vascular Function In Silent Cerebral Infraction And Its Correlation With Risk Factors For Cerebrovascular Disease

Objective:Silent cerebral infraction(SCI), also known as the resting cerebral infarction which is a special type of cerebral infarction,that is refers to the patients in the case of no obvious clinical symptoms, presence of pathological brain infarction, often in a routine check-up found by CT or MRI,many cases are found only in the presence of cerebral infarction pathology. SCI has the same pathogenesis and common risk factors as cerebral infarction(CI). Brain CT and MRI can only reflect the morphology of the cerebral infarction, it can not to judge the cerebral hemodynamics of infarction or former infarction. Cerebral vascular hemodynamic index(CVHI) which has a high detection rate on cerebral vascular function is an early warning method for patients with cerebral infraction and risk factors.SCI and cerebral infarction have the same pathogenesis and common risk factors, can be recurrent, turn to cerebral infarction,produce neurological symptoms and signs.The purpose of this study is to investigate the internal carotid artery system changes of CVHI in patients with silent cerebral infarction, and compared with stroke risk groups and normal controls, providing theoretical foundation and technical support for prevention and treatment on SCI.Method:Collected 60 hospitalized patients with silent cerebral infarction (SCI) from Department of Neurology, Beijing Military General Hospital,between August 2013 to December 2014.All of them are treated for dizziness, headache, insomnia, facial paralysis etal. Male 32 cases,Female 28 cases, The average age is 62.5±7.7, Age range 45～80, all exist ischemic lesions which found by MRI examination, with no neurological symptoms and signs of damage.Of which 51 cases of hypertension (85%),33 cases of Diabetes (55%),47 cases of Hyperlipidemia(78%).All SCI patients had supratentorial lacunar lesions,mainly in the basal ganglia, internal capsule, thalamus, lateral paraneoplastic ang corona radiata. Single lesion diameter range 2 9mm,excluding brain damage caused by cerebral infarction,cerebral hemorrhage, trauma, inflammation, cancer and so on.Pay attention to discriminate the Virchow-Robin Spaces. Collected 60 patients with cerebrovascular disease risk factors which matches to SCI group on age, sex, and history,named cerebrovascular disease risk factors group (CV-DRF),all perform cerebrovascular function tests.The patients of this group has no positive signs on neurological examination,and no infarction on imaging.Disease risk factors include hypertension,cardiovascular disease, diabetes, dyslipidemia, smoking, drinking and family history of stroke.The patients of CV-DRF group had one of hypertension, diabetes and dyslipidemia at least.Collected 60 healthy people which matches to SCI group and CV-DRF group on age, sex, and history,named normal control group(NC),all perform cerebrovascular function tests.The patients of this group has no cerebrovascular disease and cerebrovascular disease risk factors.Results:Balance test for objects of study:Pairwise comparisons of the average age by the analysis of variance.The gender distribution of the three groups was analyzed by chi-square test.There was no statistically significant difference.Age, sex among the three groups were matched. NC group, CV-DRF group and SCI group were compared each other,Cerebrovascular hemodynamic indicators have significant changes. The Qmean,Vmean,Vmax and Vmin were significantly slow down in turn (P<0.05); Reaction vessel elasticity index were significantly decreased in turn (P<0.05); Cerebrovascular resistance, pressure were significantly increased in turn (P<0.05); Cerebrovascular function total score is significantly decreased (P< 0.05);Distribution of three groups of the total integral value differences have statistical significance (P< 0. 05).Logistic regression analysis showed hypertension, diabetes, hyperlipidemia, smoking and family history of stroke are independent risk factors of stroke (OR=3.57, 95%CI:1.41-6.05; OR=2.80,95%CI:1.23-5.08; OR=2.52,95%CI:1.56-5.47; OR=1.96,95%CI:1.02-4.61; OR=1.15,95%CI:1.01-3.26)Conclusions:Cerebral vascular hemodynamic index(CVHI) of SCI and cerebrovascular disease high-risk populations, had significant changes. Suggesting that cerebral vascular function tests has a warning role in early stroke, it should take prevention on hypertension, diabetes phase.