Correlation Between The Characteristics Of Cerebral Perfusion In The Subacute Phase Of Ischemic Stroke And TCM Syndromes

Objective:To provide a basis for diagnosis,treatment and prognosis of cerebral infarction by subacute CT brain perfusion imaging characteristics and dynamic changes of TCM syndromes,to deepen the understanding of the characteristics of local cerebral perfusion and the dynamic evolution of TCM syndrome,find a better point for Chinese medicine treatment.Methods:Thirty patients with acute cerebral infarction within 72 hours of onset were enrolled in this study.Perioperative perfusion parameters,4D-cerebrovascular imaging and MIP images were obtained by routine CT scan and DWI examination.The TCM information was collected according to the Diagnostic Scale of Ischemic Stroke Syndrome,and the NIHSS scale was used to evaluate the neurological function at the first,third,fifth,seventh and 14th days.Comprehensive CT perfusion imaging characteristics,TCM syndrome changes and clinical neurological function performance,statistical analysis.Result:1.CTP imaging analysis 30 patients,28 cases in the presence of infarcted area perfusion abnormalities,there are three parameters changes infarction:① MTT prolonged,decrease the CBF,the CBV decreased;②MTT prolonged,decrease the CBF,the CBV normal or increased;③ MTT extension,normal or the CBF rise,CBV fall.② it is determined in line with reperfusion,reperfusion in this group of patients was 42.7%.There were significant differences in the MTT、CBF、CBV between ipsilateral and contralateral(P<0.05).2.Correlation between reperfusion and neurological function at each time point The scores of NIHSS in the reperfusion group were lower than those in the non-reperfusion group,and there was significant difference between the 5th and 7th day of admission(P<0.05).3.Factors affecting brain perfusion① infarction:30 patients,in the basal ganglia + brainstem infarction reperfusion incidence of10.0%,located in the corona+ radiata + cortical cerebellar infarct reperfusion rate 80.0%,basal ganglia,brainstem significant rCBV below the corona radiata,cortex,cerebellum(P<0.05).② collateral circulation and vascular stenosis:by communicating artery lesion side is open divided into two groups,each perfusion parameters between the two groups was no significant difference.There were no significant differences in the perfusion parameters and the incidence of reperfusion between the two groups(P>0.05).③ Other:reperfusion group with no reperfusion were not found significant differences in age,hypertension,diabetes mellitus,history of coronary heart disease,systolic and diastolic blood pressure between the groups aspects.4.The Evolving Pattern of Stroke Syndrome① Syndrome varying proportions:1 day of admission air ratio in the syndrome syndrome>phlegm>Blood Stasis>the fire syndrome;admission 3,5 and 7 days to blood stasis syndrome>phlegm>the fire Card is the main;Qi deficiency,Yin deficiency in the observation period is always a low proportion.② documents waiting evolution trend:in the wind syndrome admission day 1 to day 3 declined rapidly thereafter remain low.Phlegm syndrome early onset of the higher proportion of the first three days for the highest score,then gradually decreased.Blood stasis showed a slow upward trend,in the first 7 days for the highest peak score.Within the fire card,Qi deficiency showed a gradual decline in the trend.Yin deficiency basically remained stable.③ syndrome combination of evolution:the first day of admission,the most frequent syndrome is a combination of wind +phlegm + fire + Qi+ Yin,accounting for 20%,then the combination of the phlegm,fire and blood stasis syndrome occurs most.5.Correlation between Syndrome Evidence and Cerebral Perfusion Imaging The Spearman correlation analysis,on the weather deficiency syndrome 5,7,14 score was positively correlated with the contralateral CBV(r S5 =0.362,r s7= 0.385,r s14=0.389,P<0.05),by the non-parametric test,the rCBV of the group was significantly lower than that of the group without qi deficiency(P<0.01).On the 1th day,the CBF parameters of the contralateral was significantly lower in the Qi-deficiency group than that in the group without Qi-deficiency.On the 5th and 7th dany,the rCBV was significantly lower in the Qi-deficiency group than that of the group without Qi-deficiency(P<0.05).In the Spearman bivariate correlation analysis,the score of the 5th day was negatively correlated with rCBV(correlation coefficient rs =-0.397,P = 0.030),the first day deficiency score and the contralateral CBF parameters,the 7th day The correlation between rhythm and rCBV was not statistically significant.There was no significant difference in CBF,CBF,CBV and contralateral CBV and rCBV between the two groups(P<0.05).There was no significant difference between the two groups(P>0.05).Conclusion:1.CT perfusion imaging can be qualitative,quantitative display of cerebral infarction subacute cerebral perfusion.In some patients,spontaneous reperfusion occurred in the infarcted part of the infarct.The reperfusion rate may be related to the early symptoms and short-term prognosis.The incidence of reperfusion was related to the infarct site,and the perfusion rate of the cortex,radiation crown and cerebellum was higher than that of the basal ganglia and brain stem.There is no correlation was found between reperfusion rate and level of collateral circulation open situation,CTA-MIP blood flow,age,hypertension,coronary heart disease,high cholesterol,diabetes,systolic and diastolic blood pressure.2.Ischemic stroke syndromes characterized by the evolution of certain laws.Syndrome manifestations are associated with spontaneous reperfusion.The level of brain perfusion and spontaneous reperfusion rate is lower in the Qi-deficiency group.