Study Of Distribution Of Intracranial And Extracranial Artery Stenosis And Its Risk Factors Of14793Cases

Background and purpose:Intracranial and extracranial artery stenosis is important risk factor of ischemic stroke onset. Extracranial carotid stenosis is the important reason of ischemic stroke onset as for white of Europe and the United States, while for Asians, blacks and hispanics intracranial artery stenosis is more common in patients of ischemic cerebral stroke. In nearly last30years, color doppler ultrasound has being widely applied in clinical. Which provides good technical support to study the intracranial and extracranial artery stenosis distribution of large samples and stroke prevention. This study aims to explore intracranial and extracranial artery stenosis distribution characteristics of Chinese people with combined utilization of TCD and carotid artery colour ultrasound and its risk factors.Object and Methods:The trial selected the sequential outpatients and hospitalized patients for seeing a doctor in First hospital of Jilin University from January2010to December2012as the research object, and all the patients had been carried on artery examination with TCD and (or) carotid artery colour ultrasound. We applied TCD and carotid artery colour ultrasound for screening for intracranial and extracranial artery stenosis. From2010to2011, we chose1709patients with positive of both TCD and carotid artery colour ultrasound to analyze the data and further the clinical data of717 hospitalized patients of ischemic cerebrovascular disease from1709patients. And we chose14793outpatients and hospitalized patients had artery stenosis screened using both TCD and carotid artery color ultrasound the same time in2012to analyze the artery stenosis distribution. We used SPSS Statistics17.0statistical analysis software to analyze results of the trial.Results:The intracranial and extracranial artery stenosis distribution of1709patients had overall difference, and MCA stenosis was most common among intracranial vessels (1091cases,63.8%, P<0.05), while among extracranial vessels extracranial internal carotid artery was most prone to stenosis (820cases,48%, P<0.05), especially origin part of internal carotid artery (P<0.05). Analyzing TCD data of1709patients, anterior circulation arteries were more likely to stenosis relative to posterior circulation (1230:821,72%:48%, P<0.05). MCA was most prone to stenosis among the anterior circulation (P<0.05), and as for posterior circulation vertebral artery stenosis was most common (P<0.05). Analyzing the ultrasound data of14793patients, results showed that intracranial and extracranial artery stenosis existed significant differences (4255:2809,28.8%:19.0%, P<0.05), and intracranial vascular stenosis was more common. Pure intracranial artery stenosis and pure extracranial artery stenosis had significant difference in the crowd (2632:1186,17.8%:8%, P<0.05), also intracranial artery stenosis was more likely to occur. Applying layered chi-square analysis by age to the crowd, intracranial artery stenosis was more common than extracranial artery among each age group (young age group,19.7%:5.8%, P<0.05; middle age group,26.7%:14.8%, P <0.05; elderly group,34.1%:28.1%, P<0.05), and rates of intracranial and extracranial artery stenosis all increased along with age (P<0.05). Applying layered chi-square analysis by gender to the crowd, intracranial and extracranial artery stenosis was more common in male than female (intracranial, male:female was33.5%:23.5%, P<0.05; extracranial, male:female was23.2%:14.3%, P<0.05), and intracranial artery stenosis in both groups was respectively more common compared to extracranial artery (P<0.05). Taking number of stenosis arteries as standard for evaluation on artery stenosis degree, we used logistic regression analysis to analyze clinical data of717patents and concluded that male、age、history of diabetes and smoking history were independent risk factors for artery stenosis.Conclusions:Intracranial artery stenosis is more common compared to extracranial artery in cases of our study. Mere intracranial artery stenosis is17.8%, mere extracranial artery stenosis is8%, concurrent stenosis accounts for11%. Among intracranial artery stenosis MCA is the most common, while extracranial internal carotid artery stenosis, especially the start section most easily occur among extracranial artery. Male、age、history of diabetes、smoking history were independent risk factors for artery stenosis.