Study Of Risk Factors Of Intima-media Thickness In Patients With Acute Cerebral Infarction

Objective:To investigate the related risk factors of carotid artery intima-media thickness(CIMT)in acute cerebral infarction(ACI)patients.To explore the relationship among oxidized low density lipoprotein(ox-LDL),thyroid function and CIMT in ACI patients,and to assess the association between CIMT and the severity of ACI,in order to provide the basis of risk prediction,prognosis and treatment.Methods:Totally 108 patients suspected of ACI from Neurology Department of the Second Affiliated Hospital of Nanchang University was identified from March 2014 to July 2014,and divided into ACI group and control group according to the results of brain magnetic resonance imaging(MRI).Blood samples of all patients were collected from cubital veins after fasting 8 hours.All patients tested biochemical criterion including ox-LDL,free triiodothyronine(FT3),free thyroxin(FT4),thyroid-stimulating hormone(TSH),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and underwent a color Doppler ultrasound examination to detect IMT.We measured the both sides of IMT of the common carotid artery(CCA)and the carotid artery bulb(CAB),and then took the average of the both sides respectively.The same neurologist evaluated the neurological deficiency of the case group by the national institutes of health stroke scale(NIHSS).The history of hypertension,diabetes mellitus,smoking and stroke was asked at admission in all subjects.Comparative analysis between case group and control group was made,including age,gender,hypertension,diabetes mellitus,smoking,a history of stroke,blood lipids level,ox-LDL and thyroid function,and we performed a correlation analysis between the former data,NIHSS scores and CIMT.All data was used the SPSS21.0 to make the statistical analysis,and there is a statistical significance when P value is less than0.05.Results:(1)In our study we identified 108 patients including 71 males and 37 females.The range of age was from 37 to 91,and the mean age was 64.35±12.45.There were84 ACI patients including 57 males and 27 females whose mean age was 63.20±12.85 and 24 synchronous non-ACI patients including 14 males and 10 females whose mean age was 68.38±10.18.There was no statistical significance in age,gender,hypertension,diabetes mellitus,smoking,TC,TG,LDL-C and HDL-C comparing the two groups.(2)Comparing the control group,the ACI group was significantly higher ox-LDL(58.74±19.62 and 28.39±17.31 respectively,P=0.000).There was no statistical significance in CIMT,FT3,FT4 and TSH between the two groups.(3)There was a negative association between the IMT of CCA and CAB and FT3 level in ACI group(P=0.044 and P=0.045).With the FT3 increasing,CIMT value gradually decreased.Ox-LDL,FT4,TSH and CIMT have no obvious correlation.(4)The IMT of CAA and CAB was positively related to a history of stroke(P=0.001 and P=0.003).Age,gender,TC,TG,LDL-C,HDL-C,hypertension,diabetes mellitus,smoking and CIMT have no obvious correlation.(5)There was a positive association between the IMT of CCA and CAB and NIHSS scores in ACI group(P=0.004 and P=0.005).With the NIHSS increasing meaning the severity of ACI increasing,CIMT value gradually increased.(6)In the ACI group,we made a multiple linear stepwise regression,in which the CIMT was a dependent variable,and FT3 and a history of stroke were independent variable.The results showed a history of stroke enter the regression equation,and FT3 did not enter the regression equation,which indicated a history of stroke may be independent risk factors of CIMT(P=0.001 and P=0.003)and FT3 may not(P=0.205 and P=0.190).Conclusion:(1)There was an association between the IMT of CCA and CAB and FT3,but FT3 may not be independent risk factors of CIMT.And there was an association between the IMT of CCA and CAB and a history of stroke,and a history of strokemay be independent risk factors of CIMT.(2)Ox-LDL,FT4,TSH and CIMT have no obvious correlation in ACI patients.(3)There was a positive association between CIMT and NIHSS scores in ACI patients,that indicated CIMT may be association with the severity of ACI.