An Study Of Endothelial Function Measurement With Ultrasonic In Patients With Cerebral Infarction

The incidence of cerebrovascular disease in China is rising every year.It is a kind of disease with high mortality and morbidity .In addition to causing physical disability, it can also cause cognitive dysfunction.So it does great harm to the patients physically and psychologically,and put a heavy burden on families and society.Therefore, the prevention and treatment of cerebrovascular diseases is of great significance.Studies of its pathogenesis at home and abroad are so many.It has been confirmed that atherosclerosis is the pathological process of the occurrence and development of atherothrombotic cerebral infarction Changes in endothelial function involves the progress of this process from multi-channel, multi-faceted.Therefore, the study on vascular endothelial function causes more and more attention from the experts, particularly in the cardiovascular field. A large number of studies have been proven that measuring brachial artery flow-mediated dilation can assess the peripheral vascular endothelial function, but also can reflect the coronary artery endothelial function.However, such researches in the cerebral vascular area are less.Thus,if it is can be used as early assessment of endothelial function in atherosclerosis worths doing study.It has the practical significance in the early diagnosis,preventive treatment of cerebrovascular disease, and in the early detection of potential patients with cognitive dysfunction.In this study,there are 60 cases in acute cerebral infarction group and control group (healthy persons) each,These patients came from China-Japan union hospital of Jilin University outpatient and inpatient department of neurology between 2007 and 2009. The selected patients with acute cerebral infarction cerebrovascular disease accord with the diagnostic standard of the Fourth National Conference on revisions of the "diagnosis of ischemic cerebrovascular disease points" . These patients were confirmed by the skull CT or MRI. All of the subjects underwent skull CT or MRI. Carotid ultrasound were performed. Mini-Mental State Examination (MMSE) was used to assess the cognitive function of all observed objects.The level of education between cerebral infarction group and the control group was no significant difference (P>0.05).Conclusions were as follows:(1) The difference in BA-FMD between cerebral infarction group and the control group was significant.(2) According to the carotid ultrasound results, patients with cerebral infarction were divided into two groups ,the group with carotid plaques and the thick IMT group.There was a little difference between the two groups;(3) The BA-FMD both sides in the 25 cases having paralysis from patients with acute cerebral infarction was of no significant difference (P>0.05);(4) All the cases were divided into two groups according to the BA-FMD results,one with normal FMD(FMD>10%),the other with lower FMD(FMD<10%).(the normal FMD is 10%-20%). There was no significant difference between the two groups about MMSE score, but to the short-term memory score, there was difference .The score of the lower FMD group was lowerer than that of the normal group. Conclusions: (1) The BA-FMD in patients with acute cerebral infarction was impaired compared with the control group.It was impaired more seriously with the severity of carotid atherosclerosis increasing. This indicator can reflect the endothelial function and the extent of vascular atherosclerosis . It has an important meaning in prevention of cerebrovascular disease;(2) Paretic limbs of patients with acute cerebral infarction does not affect BA-FMD; (3) the impaired endothelial function may cause mild cognitive impairment.Early diagnosis, intervention ,treatment,and protection of endothelial function are important to prevent dementiaAs its nerve electrophysiology, neuroimaging, biochemical changes in specificity are poor, there is still no uniform standard for the diagnosis of MCI currently.So how to diagnose MCI early still has disputes.MMSE is applied as a screening scale in the study of cognitive function because it is simple and easy to operate.MMSE was used in this study to examine the effect of endothelial function to MCI.Because MMSE has shortcomings , the sample was small, and the onset time of observations is short, the results of this study have weaknesses.Whether the impaired endothelial function causes MCI, and whether dementia is the future development of MCI still need a long follow-up study.Therefore,it is a need to make an effective, convenient and practical screening scale and a large sample, long-term following-up study in order to find out the relationship between endothelial function and MCI. So as to find out patients with MCI early.