| Obective:In order to investigate the diagnostic value of ultrasonography in carotid atherosclerotic plaque(carotid atherosclerotic plaque,CAP)in cerebral ischemic stroke(cerebral ischemic stroke,CIS)patients,and to analyze the correlation between the ultrasonic feature of CAP,CAP-related risk factors and the incidence of CIS.To provide a reliable basis for the diagnosis,assessment,clinical intervention and follow-up of CAP,and the prevention of CIS.Method:Though retrospective analysis of 522 cases which are in-hospital patients of the first diagnosis of CIS between January,2015 to September,2016 in China-Japan Union Hospital of Jilin University.Collecting the complete clinical data,carotid ultrasound(carotid ultrasound,CUS)examination results and laboratory results of the patients.All of the patients underwent CUS examination and recorded CAP status,including CAP's lesion,ultrasonography,stability and degree of arterial stenosis.Through using SPSS 21.0 and Exce1 2016 statistics software analyze the characteristics of gender,age,lesion,CUS characteristics,stability,degree of arterial stenosis and other CAP-related risk factors(including hypertension,diabetes mellitus,coronary heart disease,dyslipidemia,smoking history,drinking history,etc.).The measurement data are expressed as`x±s,and the counting data were expressed in terms of rate or composition ratio(%).The counting data are analysis by c2 test and multivariate unconditional logistic regression analysis,the difference is statisticallly significant with P<0.05.For analysing the number of independent risk factors and the degree of arterial stenosis,use the nonparametric Spearman rank correlation test,the difference is statisticallly significant with P <0.01.Results:1.Sex and age: In these 522 cases of first diagnosed CIS patients,311 cases of males(59.6%),211 cases of females(40.4%),male to female ratio 1.5: 1.These CIS patients' age was 33-103 years old,with an average age is 65.17 ± 10.67 years old.In this study,the age of first CIS patients mainly happened at the age of 51-80 years old,a total of 447 cases(85.6%).2.Past and life history: In this study the past history about these 522 cases were the patients diagnosed with CIS for the first time is 351(67.2%)cases with hypertension,305(58.4%)cases with diabetes,336(64.4%)cases with coronary heart disease,292(55.9%)cases with dyslipidemia,314(60.2%)cases with high TG,320(61.3%)cases with high TC,295(56.5%)cases with high LDL and 303(58.0%)cases with low HDL;in life history,345(66.1%)cases with history of smoking,300(57.5%)cases with history of drinking.3.CAP distribution and CUS characteristics: Of the 522 patients,61 had no plaque(11.7%);461 had plaques(only 103 patients with stable plaques and 358 with vulnerable plaques).In 461 patients with plaque,CUS were found the number of CAP is 1351,according to the CAP location of the classification,left common carotid artery had 216(16.0%),left carotid sinus had 451(33.4%),left internal carotid artery had 88(25%),right common carotid artery had 130(9.6%),right carotid sinus had 342(25.3%),right internal carotid artery had 124(9.2%);according to CAP echo,low echo plauqe had 200(14.8%),moderate echo plauqe had 126(9.3%),mixed echo plauqe had 941(69.7%),strong echo plauqe had 84(6.2%);according to stability classification of CAP,vulnerable plaque had 571(42.3%)and stable plaque had 780(57.7%).According to the degree of stenosis,236(45.2%)were mild stenosis,156(39.5%)were moderate stenosis,81(20.5%)were severe stenosis,and 49(12.4%)were carotid occlusion.4.CAP risk factor: In the group of these 522 patients,considering whether the CAP is formation as dependent variable use single factor analysis,the results show that the formation of CAP were associated with age(29)60 years old,high TG,high LDL,hypertension,smoking history,which are had the difference statistically significant(P<0.05).In order to a deeper analysis,we use multivariate unconditional logistic regression test to analyse the fomer factors,the results showed that age(29)60 years old,hypertension,diabetes,high TG,high LDL and smoking history were the independent risk factors(?>0,OR> 1,P<0.05).5.Arterial stenosis risk factors assessment: Among the 522 patients,the number of independent risk factors was positively correlated with the degree of carotid artery stenosis(r(29)0,P<0.01),ie,the more the number of independent risk factors,the more severe of arterial stenosis.In addition,grade 3 hypertension were closely related with the rate of arterial stenosis ? 50% in the patients diagnosed with CIS for the first time(P<0.017).6.CAP stability with laboratory examination: In these 461 cases with the formation of plaque,laboratory analysis data showed that triglyceride(triglyceride,TC)and low density lipoprotein(low density lipoprotein,LDL),C-reactive protein(C-Reactive protein,CRP)and homocysteine(homocysteine,Hcy)were associated with the formation of vulnerable plaques,the difference had statistically significant(P<0.05).Conclusions:1.There were CAP with most CIS patients,which accounted for a higher proportion of vulnerable plaques.CAP most often involved in the part of the carotid sinus,especially with the left side.2.Most CIS patients have CAP,which accounted for a higher proportion of vulnerable plaques.CAP most often involved in the part of the carotid sinus,especially with the left side.3.Age(29)60 years old which is the first onset of diagnosis,smoking,hypertension,diabetes,high TG and LDL were the independent risk factors for the formation of CAP.The more the number of independent risk factors,the more severe carotid artery stenosis.4.Controlling the blood pressure below Level 3 in hypertensive patients is helping to delay the process of arterial stenosis.5.TG,LDL,Hcy,CRP and CUS examination were combined,can be used for stability assessment and monitoring of plaque. |
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