| Objective:By comparing the micro-emboli signal in the blood flow of patients with different degrees of internal carotid artery stenosis,comparing the positive rate of micro-emboli signal in different stenosis groups,this thesis is to explore the relationship between micro-emboli and internal carotid artery stenosis,provide clinical data on the occurrence and progression of ischemic strokes,and assist the choice of the timing of interventions therapy.Method:Based on the selection criteria and exclusion criteria,180 patients with internal carotid artery stenosis confirmed by imaging and 60 patients with internal carotid artery stenosis but head MRI without cerebral infarction were selected as the test subjects.The transcranial doppler ultrasound probe was used to monitor the blood flow in the middle cerebral artery,and the micro-emboli signal of the internal carotid artery in the direction of the blood flow was recorded as well except for cardiogenic and other blood-derived micro-emboli signals.At the same time,the records include basic patient data,common risk factors and imaging degree of internal carotid artery stenosis.Result:The basic data of common risk factors for internal carotid artery stenosis included two ages(56.65±6.72 in the positive group and 56.21±7.33 in the negative group).There was no significant difference in gender,age,hypertension,diabetes,hyperlipidemia and smoking history.The difference was(t=0.384,p>0.05).180 patients with internal carotid artery stenosis and 60 patients with internal carotid artery stenosis without cerebral infarction,62 patients with MES positive in cerebral infarction group,the positive rate was 34.44%;11 patients without cerebral infarction MES positive,the positive rate was 18.33%,the positive rate of the two groups was significantly different(χ2=18.66,p<0.001).According to different degrees of stenosis,a total of 240 patients were divided according to the degree of stenosis(138 mild stenosis,61 moderate stenosis,41 severe stenosis),the positive rate of microemboli in different groups was compared,microemboli positive The rates were 17/138(12.3%),21/61(34.4%),and 35/41(85.4%).There were differences in the positive rates among the three groups(χ2=80.310,p<0.001).The Bonferroni method was used to correct the test standard.For the pairwise comparison of 0.05/3=0.017,the positive rate of mild stenosis was lower than that of moderate stenosis(χ2=13.382,P<0.001),and the mild positive rate was lower than the severity(χ2=81.830,P<0.001).The positive rate was lower than the severity(χ2=25.697,p<0.001).Logistic regression was performed with stenosis as the independent variable and MES as the dependent variable.The degree of stenosis was the influencing factor of MES positive(p<0.001),and the OR value was 5.79695%confidence interval of 3.673～9.148,indicating that the internal carotid artery stenosis The degree of increase in MES positive rate is increasing.Patients with internal carotid artery stenosis were grouped according to symptomatic and asymptomatic.The positive rate of MES was compared.The symptomatic group was significantly higher than the asymptomatic group(41.13%vs.10.26%,p<0.001).Among them,4 MES-positive patients with asymptomatic internal carotid artery stenosis were followed up 1 year later and proved to have no stroke.Conclusion:l.The positive rate of micro-emboli is related to the degree of vascular stenosis,and has an increasing relationship with the severity of vascular stenosis;2.The micro-emboli in the cerebral circulation is related to the occurrence of ischemic stroke;3.Symptoms of patients with internal carotid artery stenosis have a higher positive rate of micro-emboli.Asymptomatic patients also have micro-emboli shedding,but due to the small sample size,it is not possible to accurately prove that the positive rate is predictive of stroke. |
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