| Background：The pathological basis of cerebrovascular disease is atherosclerosis(AS). Atherosclerosis involves systemic blood vessels，especially the degenerative,proliferative and non-inflammatory lesions of elastic arteries. Atherosclerosis of carotidcan reflect the whole body，so it can be used to reflect a systemic atherosclerosis"window". A large number of studies showed that carotid intima-media thickness(CIMT) increase could be used as early indicator of systemic atherosclerosis, which areindependent risk factors for cerebrovascular events, and compactly related to theincidence of cerebrovascular disease. In recent years, studies have shown that CIMT canquantify atherosclerosis progression and regression in each age group，thus plays animportant role in the pathogenesis of the stroke patients.Purpose：The present study is designed to determine the role of CIMT in theetiological diagnosis for ishemic stroke, by observing the influence of atorvastatin oncarotid artery intima-media thickness (CIMT) and the stability of the plaque, and strokerecurrence rate, thus guiding secondary prevention of stroke and clinical individualizedtreatment.Object and Methods： From July2011to May2012,191patients in theDepartment of Neurology in our hospital were diagnosed with acute ischemic stroke,and the diagnoisis is in agreement with the standards in this experiment of patients.Application of color doppler ultrasound measurements the carotid artery intima-mediathickness of the patients enrolled,the first time to measurement patient’s CIMT ofpatients, and a detailed record of the patient’s past medical history, stroke risk factorscontrol and so on.After acute period (10-14days) after treatment, start the secondaryprevention: to control the risk factors, the application based on antiplateletagents,,taking small doses of atorvastatin calcium (lipitor) drugs.After3-9months later,again follow-up measure CIMT of patients, follow-up records for all patients with stroke recurrence or not, medication or not.Consequence：1. low-dose atorvastatin calcium (10mg) after treatment can reduce a two-sidedCIMT of the common carotid artery, left P=0.037, right P=0.01,P<0.05, a statisticallysignificant difference; and The CIMT change of bilateral internal carotid artery is notobvious,P=0.288to the left, P=0.145to the right, P>0.05,the difference was notstatistically significant.2.Recurrence rates of regular medication compared with not regular medicationhave differences, X2=4.09, P <0.05, the difference was statistically significant.3. Patients with a history of cerebral infarction whose CIMT was significantlythicker than the patient of first,P=0.014, P <0.05, the difference was statisticallysignificant;And CIMT was significantly positive correlation with the incidence ofischemic stroke (double side), the correlation coefficient was0.219, P=0.01, P <0.05.4.In group of patients (CIMT0.1cm) with ischemic stroke,low-densitylipoprotein levels there are differences compared with the CIMT<0.1cm group,P=0.034,P<0.05, while CIMT increased group with the Other lipid of normal group, thedifference was not obvious significant.5.Stratified age25-50years old,50-75years, and>75-year-old patients CIMTdifference was statistically significant,age and CIMT in correlation analysis ofcorrelation coefficient is0.232, P=0.001, P <0.05, significant positive correlationbetween them, and the results of doing regression analysis show that age is the riskfactors of CIMT.6.For patients enrolled into this experiments with plaques their body mass index(25.66±3.386) was hinger than with no plaque group (24.407±3.354),P=0.028, P<0.05, the difference was statistically significance.Conclusion：1.Small doses of atorvastatin calcium tablets can decrease the thickness of theCIMT, stable plaques,ease the process of atherosclerosis, reduce the risk of recurrenceof ischemic stroke,beneficial for secondary prevention of infarction of the brain.2.The CIMT significantly positively related with the recurrence of ischemic stroke,is a risk factor for ischemic stroke.And age differences in CIMT change process play animportant role, associated with the thickening of CIMT in age, is a risk factor forCIMT.Meanwhile in the blood low density lipoprotein is also the influence factors ofCIMT. 3.Carotid artery plaque related to the level of the body mass index,carotid plaqueand ischemic cerebrovascular disease incidence significantly related, are risk factors forischemic cerebral vascular disease. |
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