Study On The Relationship Between The Changes Of Physiological Curvature Of Cervical Vertebra And Ischemic Stroke

Objective: Based on the hospital population,this study used the method of case-control study to explore the correlation between abnormal physiological curvature of cervical vertebra and ischemic stroke,and to study the effect of abnormal physiological curvature of cervical vertebra on ischemic stroke,and the influence of other risk factors on ischemic stroke,so as to provide new ideas and methods for the prevention of ischemic stroke.Methods:(1)A retrospective analysis was made on 174 patients with ischemic stroke treated in the Department of Neurology and the Department of Neurology and Rehabilitation Medicine of the Youjiang Medical College for nationalities from October 1,2019 to July 31,2020 as the observation group.174 patients with non-ischemic stroke in the same period were selected as the control group.The age of the two groups was limited to 40 to 60 years old.(2)The sex,age,smoking history,drinking history,hypertension history,diabetes history,coronary heart disease history,transient ischemic attack history(Transient Ischemic Attack,TIA),hyperhomocysteinemia(Hyperhomocysteinemia,HHcy)and other clinical data of the two groups were counted,and the laboratory data of triglyceride,total cholesterol,low density lipoprotein cholesterol and high density lipoprotein cholesterol were calculated.(3)The anterior and lateral plain films of cervical vertebrae were taken by digital X-ray imaging(Digital Radiography,DR).The physiological curvature of cervical vertebrae was measured by Borden’s method.The physiological curvature of cervical vertebrae was divided into normal and abnormal,and the abnormal types of physiological curvature of cervical vertebrae could be divided into four types: smaller,larger,straight and reverse arch.(4)Excel software was used to establish database and input data,and IBMSPSS22.0 statistical software was used to analyze the differences of clinical data,laboratory data and physiological curvature of cervical vertebrae between the two groups.Based on the multivariate Logistic regression analysis of the statistically significant indexes,we first established Logistic regression model 1,which only included hyperlipidemia,hypertension and hyperhomocysteinemia,and then established Logistic regression model 2.The model added the variable of abnormal cervical physiological curvature to the model 1 to compare the change of contribution rate to the model after abnormal cervical physiological curvature.To compare the changes of coincidence rate in predicting the occurrence of ischemic stroke.The difference was statistically significant(P <0.05).Results:(1)There were significant differences in smoking,drinking,hypertension,diabetes,coronary heart disease,TIA,hyperlipidemia,HHcy and abnormal physiological curvature of cervical vertebra between the observation group and the control group,but there was no significant difference in sex and age between the two groups(P>0.05).(2)Multivariate Logistic regression analysis showed that history of hypertension,hyperlipidemia,HHcy,cervical physiological curvature inverted arch and cervical physiological curvature straightening were independent risk factors of ischemic stroke(OR>1).The risk of ischemic stroke in patients with hypertension was 24.022 times higher than that in patients without hypertension(OR=24.022,P<0.001),the risk of ischemic stroke in patients with hyperlipidemia was 2.412 times higher than that in patients without hyperlipidemia(OR=2.412,P=0.029),and the risk of ischemic stroke in patients with HHcy was 3.122 times higher than that in patients without HHcy(OR=3.122,P=0.007).The risk of ischemic stroke in patients with cervical physiological curvature anti-bow was 2.521 times higher than that in patients with normal cervical physiological curvature(OR=2.521,P=0.029),and the risk of ischemic stroke in patients with straightened cervical physiological curvature was 2.654 times higher than that in patients with normal cervical physiological curvature(OR=2.654,P=0.015).(3)The Cox&Snell R Square of Logistic regression model 2 was 0.015 higher than that of Logistic regression model 1,and the overall percentage of Logistic regression model 2was 1.2% higher than that of Logistic regression model 1.Conclusion:(1)Smoking history,drinking history,hypertension history,diabetes history,coronary heart disease history,TIA history,hyperlipidemia,HHcy and abnormal physiological curvature of cervical vertebra are the risk factors of ischemic stroke.(2)This study found that history of hypertension,hyperlipidemia,HHcy and abnormal physiological curvature of cervical vertebra may were independent risk factors of ischemic stroke.(3)The risk of ischemic stroke in patients with cervical physiological curvature inverted arch and straightened cervical physiological curvature was higher than that in patients with reduced cervical physiological curvature and straightened cervical physiological curvature.(4)Abnormal cervical physiological curvature can improve the prediction effect of ischemic stroke model,and can combine abnormal cervical physiological curvature with other risk factors to predict the occurrence of ischemic stroke.