Cerebrovascular Reactivity Studies Of Patients With Plateau Anterior Circulation Stenosis

ObjectiveBy detecting cerebrovascular reactivity of patients with the plateau anteriorcirculation stenosis and testing the level of plasma NO, serum NCX and serum GSF-C,this essay will discuss the changeable characteristics of cerebral cerebrovascularreactivity of the symptomatic anterior circulation stenosis patients under the plateauhypoxia environment, and explore the effects on cerebrovascular regulation of plasmaNO, serum NCX and serum G-CSF. It also reveals the protectional mechanism of thepatients with anterior circulation stenosis under plateau hypoxia environment.MethodsWe enroll60patients with s anterior circulation stenosis disease who were livingin plateau （Xining-an altitude of2,300m） for a long time as the case group,30ofthem are the symptomatic anterior circulation stenosis cases and30of them areasymptomatic anterior circulation stenosis cases; In addition, to select30healthy caseswho are excluded anterior circulation stenosis by TCD and carotid artery ColorDoppler Ultrasound as a control group. The structure of their age and gender is thesame as the anterior circulation stenosis cases.（1）Using international advanced Doppler-Box Transcranial Doppler UltrasoundDetector produced by German DWL Company, we measure bilateral cerebral bloodflow velocity before and after inhaling CO₂and CO₂partial pressure at the end ofbreath by using QL software system, and then calculate the cerebrovascular reactivity.（2）Using Enzyme-linked Immunosorbent Assay （ELISA）, we test the absorbanceof plasma T-NO, serum NCX and serum GSF-C level, and then calculate relatedconcentration.Results（1） The narrow side’ CVR of symptomatic anterior circulation stenosis group significantly reduced more than non-narrow side CVR; there is statistical significance（P<0.05）. The narrow side’ CVR of symptomatic anterior circulation stenosis groupsignificantly reduced more than the narrow side’CVR of asymptomatic anteriorcirculation stenosis group; there is statistical significance （P<0.05）. The narrow side’CVR of symptomatic anterior circulation stenosis group significantly reduced morethan the non-narrow side’ CVR of asymptomatic anterior circulation stenosis group;there is statistical significance （P<0.05）. The non-narrow side CVR of symptomaticanterior circulation stenosis group significantly reduced more than the non-narrowside’ CVR of asymptomatic anterior circulation stenosis group; there is statisticalsignificance （P<0.05）.The narrow side’ CVR of asymptomatic anterior circulationstenosis group significantly reduced more than non-narrow side; there is statisticalsignificance （P<0.05）. There is no difference between the non-narrow side’ CVR ofsymptomatic anterior circulation stenosis group and the narrow side’ CVR ofasymptomatic anterior circulation stenosis group; there is no statistical significance（P>0.05）. There is no difference between the non-narrow side’ CVR of asymptomaticanterior circulation stenosis group and healthy group bilateral CVR; there is nostatistical significance （P>0.05）.（2）The content of plasma T-NO, the content of serum NCX, and the content ofserum G-CSF in each group, compare every two groups. The content in patients withsymptomatic anterior circulation stenosis is lower than the ones with asymptomaticanterior circulation stenosis in each group. The content or concentration in patientswith asymptomatic anterior circulation stenosis is lower than healthy group in eachgroup; there is statistical significance （P <0.05）.（3）The content of plasma T-NO, serum NCX and serum G-CSF was all positivelyrelated to cerebrovascular reactivity.Conclusion（1）It is safe and dependable. The cerebrovascular reactivity CVR of patients withsymptomatic anterior circulation stenosis and asymptomatic anterior circulationstenosis reduced in plateau area, and the cerebrovascular reactivity of patients withsymptomatic anterior circulation stenosis significantly reduced more than the ones with asymptomatic anterior circulation stenosis.（2） The plasma T-NO, serum NCX and serum G-CSF of patients in plateau withsymptomatic anterior circulation stenosis and asymptomatic anterior circulationstenosis reduced more than healthy control group, and the cerebrovascular reactivity ofpatients with symptomatic anterior circulation stenosis significantly reduced more thanthe ones with asymptomatic anterior circulation stenosis.（3） There are some correlations between CVR reduction and the reduction of theplasma T-NO, serum NCX and serum G-CSF in plateau area.