Clinical Value Of Carotid Color Ultrasonography And Homocysteine Detection In Severe Cerebral Infarction In High Altitude Area

Objective:To explore the clinical value of carotid color ultrasonographyand homocysteine detection in patients with severe cerebral infarctionin in high altitude area.Methods:This study included 214 patients with severe cerebral infarction,as during January 2014 to September 2015 in Qinghai People's Hospital neurology hospital patients,including 113 cases of distance from Haibei Prefecture in qinghai province(3080m),Guoluo Prefecture(3719 m)and Yushu Prefecture(3681m)local residents as plateau group(elevation>3000m);The other 101 cases are the local residents of xining(2295m),as the xining group(<3000m).And selected another 98 healthy volunteer without cerebral infarction but with medical cerebrovascular risk factors from the three cities above(>3000)from Qinghai Province People's Hospital at the same period as control group,without any blood relationship between the research objects and all is the Han nationality.Ask for details of the history of the research object and record the inspection result,both line head MRI and carotid artery colour to exceed,carotid stenosis in patients with records,plaque formation conditions,common carotid artery intima-media thickness(IMT),and patients with serum HCY and lipid assay index,1annual modified Rankin disability scale(MRS)evaluation,analyzed the correlation between the indicators and 1 year prognosis.Group and the control group on the plateau,plateau and xining group between general data,the incidence of plaques incidence,degree of vascular stenosis,vascular stenosis,carotid intima-media thickness and biochemical indicators are compared,and two and degree of different groups of carotid artery stenosis patients on the plateau above is analyzed by the indicators.Results:1.Plateau,xining group and control group check out plaques in carotid artery colour to exceed number were 87(76.99%),63(62.38%),52(53.06%),plaque detection rate difference between three groups with statistical significance(P<0.01);Plateau,xining group and control group in High Homocysteine levels(High Homocysteine,HHcy)number were 83(73.45%),69(68.32%),4(4.08%),HHcy rate difference between the three groups was statistically significant(P<0.01);The IMTthickness of the plateau group and the serum Hcy level were significantly higher than in the sinning group and the control group,and the difference was statistically significant(P<0.05).2.Narrow plateau in the group without group,mild stenosis,moderate stenosis,severe stenosis group,occlusion of the carotid artery colour to exceed to check out the number of plaques were 0(0.00%),25(73.53%),27(81.82%),27(100.00%),10(100.00%),plaque detection rate differences between groups with statistical significance(P<0.05);HHcy number 1(11.11%),respectively,17(50.00%),23(69.70%),27(100.00%),10(100.00%),HHcy rate differences between groups with statistical significance(P<0.05);The IMT thickness and serum Hcy levels were increasing,and the difference was statistically significant(P<0.05).3.The plateau in the group 1 year outcomes for patients with carotid artery stenosis degree different composition show that no stenosis group,mild stenosis,moderate stenosis,severe stenosis and occlusion group of patients with poor prognosis respectively 0(0.00%),4(11.76%),2(6.06%),2(7.41%),9(90.00%),poor prognosis rate difference was statistically significant(P<0.05);In patients with poor prognosis,the incidence of HHcy and the level of Hcy increased with the increase of carotid stenosis,and the difference was statistically significant(P<0.05).Conclusion:1.HHcy,carotid stenosis and the formation of plaques are closely associated with the occurrence and prognosis of severe cerebral infarction in high altitudes.2.The serum Hcy levels were significantly elevated in patients with severe cerebral infarction in high altitudes,and serum Hcy levels were associated with carotid stenosis.3.With HHcy carotid stenosis could be high altitude severe cerebral infarction important predictor of poor prognosis,early lines of carotid artery colour to exceed and plasma Hcy levels check and carry on the intervention treatment as soon as possible for high altitude control and prognosis of severe cerebral infarction has important significance.