| Objective:To explore the risk factors of dizziness in patients with new onset anterior circulation infarction(ACI)and its relationship with the morphological changes of internal carotid artery(ICA)system.To explore the impact of severe carotid stenosis on health-related quality of life(HRQoL)and then to assess the effects of carotid stenting(CAS)on HRQoL in dizzy patients with severe carotid stenosis.Methods:From July 2016 to July 2018,234 patients with new onset anterior circulation cerebral infarction(ACI)hospitalized in the department of neurology of the First Affiliated Hospital of Soochow University were enrolled in this study.All patients underwent cranial MRI and total cerebral angiogram by DSA,exclude vertebrobasilar artery(VBA)disease.The 234 patients were divided into dizziness group and non-dizziness group based on whether dizziness occurred within 24 hours before new onset cerebral infarction.The demographic characteristics,general clinical data and imaging data of the patients were collected.The morphological changes of arteries in ICA system,the patterns of collateral circulation and vascular risk factors(VRFs)between the two groups were analyzed.In the First Affiliated Hospital of Soochow University,the patients with severe carotid stenosis,complained of dizziness and received CAS were recruited.Two HRQoL questionnaires,the 36-item Short-Form Health Survey and the Dizziness Handicap Inventory,served as outcome measures.The patients were followed in 1 day prior to CAS,1 month and 6 months procedurally and their differences in HRQoL before and after CAS were compared.Experimental data were analyzed using SPSS22.0 statistical software package.Results:1.There was no difference in the overall age and gender composition ratio between dizziness group and non-dizziness group.The incidence of hypertension,total cholesterol,low density lipoprotein cholesterol(LDL-C),VRFs>3 in dizziness patients significantly higher than those in non-dizziness group.Multivariate regression analysis showed that higher LDL-C(OR=0.693,P=0.035)were independent risk factors for dizziness happened in ACI patients.2.Patients with ACI had ICA stenosis and tortuosity,mostly showing severe ICA stenosis(OR=1.480,P=0.013)and moderate ICA tortuosity(OR=1.212,P=0.019).The proportion in the dizziness group was significantly higher than that in the non-dizziness group and the difference was statistically significant.3.There were no statistically significant differences between the dizziness group and the non-dizziness group in the location of infarction,open collateral branches and embryonic posterior cerebral artery of dizziness in ACI patients.4.Compared to controls,it was noted that 31 dizziness patients with severe ICA stenosis tallied lower scores in five(physical functional,physical problems,vitality;social functioning andemotional problems)out of eight domains of the 3 6-item Short-Form Health Survey score(p<0.01).5.1 month after CAS,significant improvement was gotten in the overall total and two subscales(physical and functional)of the Dizziness Handicap Inventory(p<0.025),and similar findings were noted in two(social functioning and emotional problems)out of eight domains of the 36-item Short-Form Health Survey score(p<0.01).6.6 months after CAS,significant improvement showed in overall total and three subscales(physical,functional and emotional)of the Dizziness Handicap Inventory(p<0.01),and so to with HRQoL(role physical,bodily pain,general health,social function and role emotional)in these patients(p<0.01).Conclusion:1.The higher the LDL-cholesterol,the higher the incidence of dizziness happened in ACI patients.2.Severe ICA stenosis and moderate ICA tortuosity are independent risk factors for dizziness in ACI patients,which deserves an attention for clinical workers.3.Dizzy patients with severe internal carotid artery stenosis have significantly depressed HRQoL score.4.CAS for dizziness patients with severe carotid stenosis resulted in significantly improved in HRQoL score. |
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