The Relationship Between Ankle Brachial Index Combined With C Reactive Protein And Symptomatic Middle Cerebral Artery Stenosis

Research BackgroundIschemic cerebrovascular is a serious disease which harms human health, it’s incidence keeps climbing dramatically these years. One of the main reasons of ischemic cerebrovascular disease is intracranial atherosclerosis. Thus, early detection of high-risk groups of intracranial atherosclerosis and taking measures to intervene the intracranial atherosclerosis development process immediately is the key point to reduce the incidence of ischemic cerebrovascular disease. Recently, studies have shown that the Ankle Brachial Index (ABI) and high sensitivity C-reactive protein (hs-CRP) are associated with atherosclerosis, but their limitation are only useful for evaluating peripheral artery disease. Although some researches focused on prediction of symptomatic artery stenosis, but most of them limited in only one aspect of these objects. Thus, exploring the correlation between ABI and hs-CRP, as well as their contribution to symptomatic middle cerebral artery stenosis needs further research.Objective.To determine whether ankle brachial index (ABI), high sensitivity C-reactive protein (hs-CRP) have correlation with symptomatic middle cerebral artery (MCA) stenosis or not. Based on that, we provide a simple, reasonable and accurate forecasting method to evaluating stenosis of symptomatic middle cerebral artery effectively.Methods1. Case choosing Total 100 patients were enrolled since 2014.11 to 2015.11 in Shandong Police Hospital and Shandong Electric Power Center Hospital. All the patients were diagnosed as acute cerebral infarction in middle cerebral artery blood supply region by using magnetic resonance diffusion weighted imaging (DWI), and all the patients were diagnosed as Middle Cerebral Artery stenosis by using magnetic resonance angiography (MRA) and cerebral ultrasonic doppler (TCD) examination. Among these 100 cases,53 cases were male,47 cases were female, aging (62.16+ 9.78).2. All data including patients’ABI, hs-CRP and the degree of symptomatic MCA stenosis and other parameters were recorded. Further study analyzed the correlation between these indicators and symptomatic MCA stenosis.3. Statistical analysis has been done by using statistical software SPSS 19.0 analysis, measurement data using mean±standard deviation (x±s) said, using T test detected measurement data, Multiple sets of comparison between the single factor used One-Way ANOVA, Variable correlation test according with normal distribution used Pearson correlation analysis, discrepancy normal distribution or level data used Spearman correlation analysis. With P<0.05 for the difference is statistically significant.ResultsSymptomatic intracranial arteries in the brain severe stenosis group compared with the no severe stenosis group, ABI, hs- CRP have significant difference.There is a negative correlation between stenosis degree of MCA and ABI, (r=-0.435, P<0.05). However, stenosis degree of MCA has a positive correlation with hs-CRP (r=0.762, P<0.05). The specialness of judging stenosis degree of MCA by using ABI (cutting point:ABI<0.9) together with hs-CRP (cutting point:hs-CRP>3mg/L) is 95.9%, which was significantly increased (P<0.05). Meanwhile, the sensitiveness declines.Conclusion1. Severe stenosis group compared with the no severe stenosis group, ABI, hs CRP had significant difference (P<0.05)。2. There is correlation among ABI, hs-CRP and stenosis degree of MCA.3. There is a negative correlation between stenosis degree of MCA and ABI.4. Stenosis degree of MCA has a positive correlation with hs-CRP.5. The sensitiveness of judging stenosis degree of MCA by using ABI (cutting point: ABI<0.9) together with hs-CRP (cutting point:hs-CRP>3mg/L) is high.6. ABI< 0.9 joint hs-CRP> 3 mg/L the sensitivity of the detection of severe stenosis group was 42.3%,95.9%. So the ABI<0.9 joint hs-CRP> 3 mg/L, to severe middle cerebral artery stenosis or chronic block has a certain sensitivity and good specificity. ABI<0.9, or joint hs-CRP> 3 mg/L to predict severe middle cerebral artery stenosis or chronic occlusion with moderate predictive value..It is low sensitivity and specificity is higher.