Font Size: a A A

Clinical Research Of Cerebral Hemodynamic Evaluation By TICI Grade In Patients With Acute Cerebral Infarction

Posted on:2015-03-25Degree:MasterType:Thesis
Country:ChinaCandidate:N Y TanFull Text:PDF
GTID:2254330428496100Subject:Clinical medicine
Abstract/Summary:PDF Full Text Request
Cerebral artery stenosis caused by atherosclerosis and its subsequent lumenocclusion is the leading cause of ischemic cerebrovascular disease, and thisphenomenon will result in abnormal hemodynamic in corresponding blood-supplyarea, causing cerebral ischemic hypoxic damage, constituting the main pathology andpathophysiology process of ischemic cerebrovascular disease.With the developmentof imaging technology,there are many methods to evaluate cerebral blood flowdynamics in cerebral infarction, for example, CTP、MRPWI、PET、CTA、MRA andso on. DSA is the gold standard of vascular examination. It can reflect the positionand degree of vascular occlusion, the status of vascular recanalization and bloodreperfusion, extent of collateral circulation, etc. DSA also acts as a method to evaluatecerebral hemodynamic. In addition to observing the static change of distalcerebrovascular perfusion, MRA and CTA can assess dynamically the dynamics ofcerebral blood flow to some degree.At present the most common clinical assessmentmethod,CTA, MRA and DSA, can only provide objective index of image information.Although this kind of result is visual, they are difficult to quantify.As a result, it hasan important clinical significance to evaluate perfusion in distal infarction area byquantitative indexes.Thrombolysis in myocardial infarction (TIMI) classification mainly used forevaluation of distal blood flow after coronary artery occlusion reperfusion. TIMIclassification was improved to thrombolysis in cerebral infaretion (TICI) grade whenHigashida, etc, doing DSA in patients with acute cerebral infarction. using it toevaluate the distal blood flow of the position of cerebral vascular occlusion afterreperfusion.Someone is trying to apply TICI to CTA.Using it to evaluate the distalblood flow of the position of cerebral vascular occlusion after reperfusion. This articlerefers to TICI grade in CTA, studying of reperfusion of distal blood flow in MRA of cerebral infarction patients, discussing the relationship between TICI grade andclinical manifestation, prognosis and cerebrovascular risk factors. And make thefurther determination whether TICI grade can evaluate the illness severity, prognosis.And research cerebrovascular disease risk factors which can affect TICI grade.This study selected147cases of patients with acute cerebral infarction. AfterMRA examination, we classified the vascular responsible to acute cerebral infarctionwith TICI grade. There were72patients performed normally in MRA (TICI level Ⅲ),and75patients reperfused insufficiently in distal parts in MRA (TICI level0-Ⅱ).Theocclusion in MCA is the most common in abnormal MRA (56patients).Therefore, wetake the MCA affected patients as the research object,grouping of different TICIgrade patients, divided into TICI level0, class I and class II.Making statistics of thethree groups with NIHSS score, Barthel score, risk factors of cerebrovascular disease.General description applied percent. Applied two independent sample T test withsamples conforming to normal distribution of two independent sample and varianceanalysis in comparison of three groups of data conforming to normal distribution ofthree independent samples. If the samples did not conform to the normal distribution,we used the rank and inspection. Comparison between enumeration data applied2test. P <0.05was statistically significant. SPSS17.0software was used tostatistical processing and Excel was used to plot. In the research of relationshipbetween TICI grade and risk factors in cerebrovascular disease, only low densitylipoprotein difference between different TICI grade was statistically significant (P=0.011), that the higher the TICI grade category, the smaller the value of low densitylipoprotein. While smoking, drinking, hypertension, diabetes, triglyceride, cholesterol,fasting glucose, age between different classification in TICI difference were notstatistically significant. In the study of TICI grading and NIHSS score, differencebetween the three groups were statistically significant (P <0.05). In the study of TICIgrading and Barthel score,1case death,8cases were lost to follow-up, the differencebetween the3groups had statistical significance (P <0.05).By the above-mentioned research, we can get the following conclusions: TICIgrade can reflect the severity and prognosis of clinical symptoms. The higher the TICIgrade, the lower the NIHSS score, the less serious in patient’s condition. The higher the TICI grade, the higher the Barthel score, the better the prognosis of patients. Lowdensity lipoprotein levels are related to the TICI classifications.It indicates TICIclassifications can be one of indicators of grading and quantifying of cerebralinfarction risk assessment.
Keywords/Search Tags:Cerebral infarction, TICI Grade, Cerebral hemodynamics, Low-densitylipoprotein
PDF Full Text Request
Related items