| Objective: Computed tomography angiography(CTA)and computed tomography perfusion imaging(CTP)technology was used to exam The patient which is Acute ischemic stroke with severe stenosis or occlusion cuased by the unilateral middle cerebral artery(MCA),to compare the relationship between the different risk factors,collateral circulation,cerebral perfusion,and cognitive of this Patients.Methods: 53 patients which with severe ischemic stroke caused by severe stenosis or occlusion of unilateral MCA,using CTA and C TP to check all the 53 patients.According to the collateral circulation results,we divide the patients into two groups.And then we compare the risk factors,CTP values,and MOCA score.Results: There are Male 36,female 17 in all cases enrolled in the group.15 patients with coronary heart disease(28.3%),11 patients with hyperlipidemia(20.8%),17 with diabetes(32.07%),36 patients with hypertension(73.6%),9 patients with smoking(16.98%),19 patients with drinking(35.84%).Compare the group of collateral circulation and the group without the collateral circulation,by using the quantitative data t test,we find the diabete is an important factor,because it has significantly difference between the two group(P <0.05),In Age,gender,hypertension,coronary heart disease,hyperlipidemia,smoking,drinking,triglycerides,cholesterol,HDL,LDL,admission fasting blood glucose there was no difference between the group with or without collateral circulation(P> 0.05).To compare the TTP,MTT,CBV,CBF and MOCA scores between collateral circulation and non-collateral circulation groups,the results showed the value of MOCA,CBV and CBF the collateral circulation group was higher than that with no collateral circulation group.And the P value showed the difference in CBV,MOCA between the two groups because the P value(P <0.05)The MOCA score,but MTT 、TTP、C BF has no difference between the two group.Then we used the logistic regression analysis to check all this data,we found the score of MOCA,diabete,and CBV showed the difference between the two groups because the P value(P <0.05).Based on the results,patients with high MOCA scores and patients with high CBV values would be more easier to eastablish the Collateral circulation,this two factors are the benefits(OR <1),while patients with diabetes history would be more difficult to eastablish collateral circulation(OR > 1).TO compare the values(named attention language abstract delay memory orientation)of the MOCA in two groups.According to t-test results,visual space,naming,and attention were significantly different between the two groups..Conclusion: 1.Diabetes is a risk factor that affects the establishment of collateral circulation in patients with acute occlusion or stenosis of the midd le cerebral artery.This may be diabetes can affect the lipid metabolism,causing metabolic disorders,lipid deposition in the blood vessel wall,leading to extensive vascular degeneration,atherosclerosis formation.2.CVB is volume of the vascular in a unit volume of brain tissue which can reflect collateral circulation formation of those patients whose the middle cerebral artery occlusion or stenosis,then to guide doctors choose clinical treatment.3.The acute ischemic stroke patients who with severe stenosis or occlusion cuased by the unilateral middle cerebral artery,those who with good collateral circulation has higer cognitive function score than those without collateral circulation.The results will help clinical diagnosis,to choose the best treatment for patients.4.The establishment of collateral circulation affects the visual field,naming and attention of patients with acute ischemic stroke... |
PDF Full Text Request