The Risk Factors Of Aortic Atherosclerosis And The Relevance Between Aortic Atherosclerosis And Intra-and Extracranial Atherosclerosis

Objective：Atherosclerosis is a main cause of cerebral infarction, and intra-andextracranial atherosclerosis are the most common causes of cerebral infarction. In manyclassifications of ischemic stroke, cerebral infarction with unclear cause holds a largeproportion. Domestic and foreign researches on aortic arch atherosclerosis are less in thepast, many clinical observations find that the aortic arch plaques(AAP) may be the maincause of cerebral infarction with unclear cause. This study is to explore the risk factorsof the aortic arch atherosclerosis and to investigate the relevance between aortic archatherosclerosis and intra-and extracranial atherosclerosis. This has important clinicalsignificance to find out the cause of cerebral infarction and reduce the proportion ofinfarctions with unclear cause.Method：Total140patients with ischemic stroke/transient ischemic attack(TIA)were enrolled from November,2010to February,2012in the first affiliated hospital ofDalian Medical University. Take CTA examination to their aortic arch and internal andexternal cranial arteries. According to the appearance of the aortic atheroscleroticplaques, we divide the patients to plaque group and control group. Detect the hs-CRP、total cholesterol、LDL-C、LP（a）、HCY、, triglycerides and other indicators from theserum of the two groups patients. And then use statistics to analyze them. Also, usestatistics to analyze the relevance between aortic arch atherosclerosis and internal andexternal atherosclerosis.Result：1. Advanced age（＞65），male，smocking，high blood pressure，diabetes，high HCY， high total cholesterol， high triglycerides， high LDL, high LP（a）, low HDL-C, the ESSEN score≥3are related to the aortic arch atherosclerosis(P＜0.05）,female and fibrinogen have no relationship to aortic arch atherosclerosis(P＞ 0.05).2.The amount of risk factors aggregate has significant difference in the formationof aortic arch atherosclerosis.3. Of all the140patients,110cases we found aorticarch atherosclerotic plaque (AAP),97cases we detected external cranial atheroscleroticplaques,107cases we detected internal cranial atherosclerotic plaques. Patients withaortic arch plaque(AAP) have higher incidence of extracranial atherosclerosis（81cases，83.5%） than the patients without AAP （16cases，17.5%）,OR=3.232,P=0.01.Alsopatients with AAP have higher incidence of intracranial atherosclerosis（93cases，86.9%） than the patients without AAP（14cases，13.1%）,OR=1.411,P=0.02.Conclusion：1.Advanced age, male, smoking, high blood pressure, diabetes,high HCY, high total cholesterol, high triglycerides, high LDL-C, high level of LP(a)、low level of HDL-C are the important independent risk factors of the AAP.2.The moredifferent risk factors accumulate, the greater of the risk of aortic archatherosclerosis.3.Aortic arch atherosclerosis has clear relevance with intra-andextracranial atherosclerosis.