A Preliminary Study On The Pathogenesis And Treatment Strategies Of Patients With Posterior Circulation Ischemia

Objective: To study the clinical characteristics of patients with posterior circulation ischemia and to analyze the risk factors of patients with different characteristics for laying the foundation for the evaluation,treatment and prognosis of the patients with post clinical circulation ischemia.Methods: 240 patients with posterior circulation ischemia atn the neurology department in the Affiliated Hospital of Qiingdao University from September 2013 to September 2016 were randomly selected as the study group,and then 240 cases with anterior circulation ischemia in this stage were selected as the control group.The basic data of the subjects were collected and then grouped according to the cranial imaging features and segmentation criteria.The patients were divided into four groups,namely middle group,proximal group,mixed segment group and distal group according to the location of the attack.The patients were divided into multi focus group and single focus group by the number of focus.The patients were divided into bilateral focus group and unilateral focus group by the focus distribution,and the patients were divided into cavity infarction and non cavities group by lacunar infarction.The data and the risk factors of patients were collected and compared in each group.Result:1.The symptoms of the patients with posterior circulation ischemia were usually characterized by weakness of the limbs,dizziness and dysarthria,and most of the signs are ataxia,abnormal sensation,and closure of the eye.2.The proportion of the subclavicular artery in the posterior circulation ischemia was 26.32%,the proportion of the subclavicular artery was 3.4%,the proportion of the basilar artery was 18.18%,the proportion of the posterior cerebral artery was9.57%,the proportion of the intracranial vertebral arteries was 16.75%,and the proportion of the vascular lesions was 16.75%.3.The length distribution of the study group was statistically different with that of the control group(P<0.05),and the ratio of "3w" and "2-3w" in the study groupwas significantly higher than that of the control group(P<0.05).4.There was no significant difference on the prognosis between study group and the control group(P>0.05).5.The incidence of hemorrhage in upper digestive tract and infection in the study group was significantly higher than that in the control group(P<0.05).There was no statistical difference on the incidence of cerebral heart syndrome between the two groups(P > 0.05).6.The highest incidence of the risk factors of posterior circulation ischemia in the study group was hypertension,and the proportion was 70.41%.The second was diabetes,and proportion was 45.83%.The proportion of hyperlipidemia was 42.50%,and proportion of previous stroke history was 37.08%.The rate of heart disease was29.17%,and history of smoking was 25.41%.The rate of alcohol drinking was the lowest(17.08%).7.The age of patients in the study group was significantly higher than that of the control group(P<0.05).The proportion of hypertension,hyperlipidemia and diabetes in the study group was significantly higher than that of the control group(P<0.05).The proportion of drinking history,smoking history and heart disease history in the study group was significantly lower than that of the control group(P<0.05).8.The proportion of male drinking history,smoking history and history of stroke in the study group was significantly higher than that of women(P<0.05).The rate of male heart disease and diabetes in the study group was significantly lower than that of female(P<0.05).9.The incidence of the distal group was the highest in posterior circulation ischemia(34.93%),while the proximal group was the lowest(12.50%).The age of the proximal group was significantly lower than that of the other groups(P<0.05).The proportion of hyperlipidemia in the proximal group was significantly higher than that in the other groups(P<0.05),and the rate of heart disease in the distal group was significantly higher than that in the other groups(P<0.05).10.The proportion of hyperlipidemia in the single focus group was significantlyhigher than that in the multifocal group(P<0.05).The proportion of previous stroke history in the single focus group was significantly lower than that in the multifocal group(P<0.05).11.The rate of diabetes history in the infarction group were significantly higher than those in the non infarction group(P<0.05).The ratio of the heart disease history and hyperlipidemia in the infarction group was significantly lower than that in the non infarction group(P<0.05).Conclusion:1.The symptoms of posterior circulation ischemia are varied.The symptoms of limb weakness,dizziness and dysarthria are often seen,and signs include ataxia,abnormal sensation,and occlusion,and the diagnosis should be avoided according to single symptom.2.Patients with posterior circulation ischemia usually suffer from middle age and old age.They are prone to cause multiple complications and are more difficult to treat.3.The most common location of the posterior circulation infarction is the distal segment,then the middle and the mixed segment.The patients in the proximal segment are usually accompanied by hyperlipidemia,and the patients in the far segment often have history of heart disease.4.The risk factors of posterior circulation ischemia can include hypertension,hyperlipidemia,diabetes and stroke history.