Comparative Analysis Of Head And Neck CTA Characteristics And Risk Factors In The Young,Middle-aged And Elderly Patients With Acute Ischemic Stroke

Objective:By comparing and analyzing the differences in head and neck CTA imaging characteristics and risk factors between young and middle-aged and elderly patients with ischemic stroke,the aim is to provide theoretical basis for the diagnosis,prevention,and treatment of young patients with ischemic stroke.Methods:132 cases of young patients with acute ischemic stroke who received treatment in Chengde Central Hospital from January 2015 to June 2020 were selected as the experimental group.I collected the related clinical information(including age,gender,history of history of high blood pressure,diabetes,coronary heart disease history,smoking history,drinking history,migraine),related biochemical indexes(including blood sugar,triglyceride,cholesterol,uric acid and homocysteine),DWI and CTA imaging data(including Site of infarct,site and degree of vascular stenosis);A total of132 cases of middle-aged and elderly patients with acute ischemic stroke who were hospitalized during the same period were randomly selected as the control group,and the above dates were also collected.We compared the differences in CTA imaging characteristics and risk factors between the two groups withX~2test and Fisher exact test.Results:1 The proportion of males in the youth group and the middle and old group is higher than that of females,with 76.52% in the youth group and64.39% in the middle and old group;In the young group,102 patients whose age is from 36 to 44 years old accounting for 77.27%.2 Comparison of imaging characteristics between the two groups2.1 There is no significant difference in the infarct site between the young group and the middle and old group(P>0.05).The basal ganglia region is the most common site of infarct in all patients.2.2 The proportion of simple intracranial vascular stenosis in the young group is higher than that in the middle-aged and elderly group(50.76%vs18.10%),The proportion of simple extracranial vessel stenosis and both intracranial and extracranial vessel stenosis in the young group is lower than that in the middle-aged and elderly group(11.36%vs23.28%,29.55%vs57.76%),and the difference is statistically significant(P<0.05).2.3 The proportion of simple anterior circulation stenosis in the young group is higher than that in the middle-aged and elderly group(53.03%vs39.39%),the proportion of anterior and posterior circulation stenosis in the young group is lower than that in the middle-aged and elderly group(29.55%vs47.73%),the difference was statistically significant(P<0.05).The proportion of posterior circulation stenosis in the young group was lower than that in the middle-aged and elderly group(9.09%vs11.36%),but the difference is not statistically significant(P>0.05),2.4 There are 326 stenosis in the young group,among which 62 stenosis in the middle cerebral artery is the most common site,followed by the intracranial segment of the internal carotid artery(52)and the extracranial segment of the internal carotid artery(37).In the middle-aged and elderly group,there are 955 stenosis,among which 245 stenosis are found in the intracranial segment of the internal carotid artery,which is the most common stenosis site,followed by the beginning of the extracranial segment of the internal carotid artery(166)and the bifurcation of the common carotid artery(142).2.5 The proportion of mild stenosis in the young group is 65.64%,which is higher than that in the middle-aged and elderly group(53.09%),and the difference was statistically significant(P<0.05).The proportion of moderate and severe stenosis in the young group is lower than that in the elderly group(15.03%vs21.15%,11.66%vs17.17%),and the differences are statistically significant(P<0.05).The proportion of vascular occlusion in two groups is similar(7.67%vs8.59%),and the difference is not statistically significant.2.6 The proportion of patients with no stenosis and ≤2 vessels stenosis in the young group is higher than that in the middle-aged and elderly group(8.32%vs1.52%,60.61%vs14.39%),The proportion of multiple vessel stenosis in the young group is significantly lower than that in the middle-aged and elderly group(31.06%vs84.09%),and the difference is statistically significant(P<0.05).3 Comparison of risk factors between the two groups3.1 The top three risk factors in the youth group are hypertension(61.36%),hypertriglyceridemia(56.06%)and smoking(51.52%);The top three risk factors in the middle-aged and elderly group are hypertension(78.03%),hypertriglyceridemia(43.18%)and diabetes mellitus(37.88%).The proportion of patients with hypertriglyceridemia,smoking,migraine and hyperuricemia in the young group is higher than that in the old group(56.06%vs43.18%,51.52%vs35.61%,14.39%vs 6.6%,31.82%vs19.70%),the differences are statistically significant(P<0.05).The proportion of patients with hypertension,diabetes and coronary heart disease in the young group is significantly lower than that in the middle-aged and elderly group(61.36%vs78.03%,15.91% vs37.88%,9.09% vs 30.33%),the differences are statistically significant(P<0.05).3.2 The proportion of patients whose infarction area is supplied by middle cerebral artery with hypertension in the young group is 80.33%,which is significantly higher than that in the patients with infarction area supplied by anterior cerebral artery(45.83%),vertebrobasilar artery(46.88%)and multi-vessel(40.00%)with hypertension,and the differences are statistically significant(P<0.05).Diabetes mellitus,coronary heart disease,smoking,drinking,hypercholesterolemia,hypertriglyceridemia,migraine,hyperhomocysteinemia and hyperuricemia have no statistical differences among infarcts in different arterial supply areas(P>0.05).Conclusion:1 The incidence of ischemic stroke in young males is higher than females.Among the young patients aged 36 to 44,the risk of the disease is significantly higher.2 The young patients with ischemic stroke in the head and neck artery prone to stenosis,the proportion of extracranial and intracranial artery stenosis,the proportion of anterior and posterior circulation stenosis,the number and degree of vascular stenosis,and the prevalence of different risk factors are different with the middle-aged and elderly,which prompts that the pathogenesis of the youth with ischemic stroke is different with the middle-aged and elderly.It remains to be prospective,large sample of case control experiment to confirm.