The Distribution Of Intracranial And Extracranial Artery Stenosis And The Analysis Of Related Risk Factors

Background：The aging of the society brought great problems to our country and community,modern lifestyles and eating habits made the atherosclerosis risk factor prevalentwidely. The incidence of ischemic cardiovascular and cerebrovascular disease isincreasing year by year, accounting for the leading cause of death and disabilityworldwide, especially in China. Intracranial arterial stenosis has been considered oneof the factors that lead to ischemic cerebral infarction, but not the major factor.Butrecently we found that LAA occupies a large proportion of all cause ischemic stroke.Among the reasons,besides the popular of AS itself,advances in neuroimaging andinterventional technology are the most important driving force, they improved thestatus of cerebrovascular stenosis awareness,especially the ICAS.The recent researchhave beginning to focus on the ICAS gradually.With a view to the data ofepidemiological and clinical research home and abroad,we found that there is anethnic difference in the distribution of ICAS and ECAS.And the reasons are stillunclear.Most of the outdated viewpoints is that,the pathology and incentives of ICASand ECAS are approximately the same.So we didn’t treat them discriminatorily. Butwith a growing body of recent data doubting the views, we started to explore thepotential differences,and make the targeted treatment possible.Objectives：To explore the distribution of intracranial and extracranial artery stenosis of theICVD patients in our hospital and the relationship between risk factors and theintracranial and extracranial stenosis. Methods：This is a retrospective analysis study. We generally investigated all the ICVDpatients hospitalized, with the clinical features and imaging results, diagnosis is madeby definition.In the end199patients were included in. We divided them into4groups:ICAS、ECAS、I&ECAS、NECAS。Demographic features and vascular riskfactors were collected, and were compared between groups.Results：1. Among the symptomatic ICVD patients in our hospital, ICAS rate is far beyondthat of ECAS（74.4%vs51.3%，P=0.001）.MCA is the most common artery related inthe ICAS，while the extracranial segment of the carotid artery is the most commonartery related in the ECAS.2. Univariate analysis results：(1)When ICAS is compared with NCAS，the risk factors that significant：FPG（P=0.0001）、GHbA1C（P=0.0002）、HDL（P=0.004）、hs-CRP（P=0.0063）、hypertension（P=0.010）、age（P=0.011）、smoking（P=0.021）、LDL（P=0.022）、Cystatin C（P=0.028）、diabetes（P=0.029）.(2)When ECAS is compared with NCAS，the risk factors that significant：Cystatin C（P＜0.0001）、age（P＜0.001）、gender（P=0.002）、Fig（P=0.002）、hypertension（P=0.023）、FPG（P=0.029）、hs-CRP（P=0.035）、UA（P=0.037）。(3)When ICAS is compared with ECAS，the risk factors that significant：diabetes（P=0.002）、GHbA1C（P=0.0038）、Cystatin C（P=0.005）、age（P=0.011）、UA（P=0.043）.3. Logistic regression results：(1) When ICAS is compared with NCAS, the significant risk factors include: GHbA1C（OR=5.437）、hs-CRP（OR=1.627）.(2) When ECAS is compared with NCAS, the significant risk factors include:male（OR=6.267）、Cystain C（OR=6.621）、FPG（OR=2.015）、hs-CRP（OR=1.229）、age（OR=1.092）.(3) When ICAS is compared with ECAS, the significant risk factors include:diabetes（OR=16.617）、GHbA1C（OR=2.921）. Conclusions：1. Among the symptomatic ICVD patients in our study, ICAS rate is far beyondthat of ECAS.MCA is the most common artery related in the ICAS，while theextracranial segment of the carotid artery is the most common artery related in theECAS.2. The differences between ICAS and ECAS do exist. The risk factors of ICASincludes GHbA1C、 hs-CRP; the risk factors of ECAS includes Male、age、FPG、Cystain C、hs-CRP; Diabetes mellitus are far more tend to ends in ICAS.