Analysising The Correlation Factors Of The Degree Of M1 Segment Stenosis Of The Middle Cerebral Artery

Objective : We conducted a study to determine which factors are associated with the progression and the regression of MCA M1 segment stenosis in ischemic cerebral vascular disease,and anslysesed the age and sex provided Suggestions to prevent the progress of the stenosis MCA M1 segment and to promote its improvement.Methods:257 patients with MCA M1 segment stenosis were selected according to the inclusion and exclusion criteria,collecting the two times MRA data scaned by 3.0T nuclear magnetic resonance apparatus of these patients,and the patients were divided into improved group,stable group,progressive group based on changes of MCA M1 segment in the two MRA scanning,Univariate analysis and multivariate logistic regression were used to analysis the factors related to the progression and improvement of MCA M1 segment.Results:Data characteristics:(1)There were 174 males(67.7%),83 female patients(32.3%)in the 257 patients,the ratio was 2.1:1;(2)All the patients were 26~85 years old,mean 61.71±11.50 years old,and these patients were divided into youth group(26 ~ 45 years old)20 cases(7.8%),middle-aged group(46 ~65years old)126 cases(49%)and elderly group(66~85 years old)111 cases(43.2%);(3)All the 257 patients were divided into 3 groups,of which 41 cases(16%)were improved group,75 cases(29.2%)were stable group and 141cases(54.8%)were progressive group.Data analysis:(1)Improved group and non-improved group(stable group plus progressive group): Univariate analysis showed that the age less than 60 years,without diabetes,without coronary artery disease,without dyslipidemia,no-smoking,anticoagulation/antiplatelet therapy,anti-atherosclerosis treatm-ent,without ipsilateral recurrent cerebrovascular events had statistical significance between the two groups;Multivariate logistic regression showed that anticoagulation/antiplatelet therapy(OR=0.05,95%CI: 0.02~0.25,P <0.001),no recurrence of ipsilateral cerebrovascular events(OR=0.07,95%CI:0.02~0.23,P < 0.001),anti-atherosclerosis treatment(OR=0.17,95%CI:0.02~0.54,P=0.027),without dyslipidemia(OR=0.21,95%CI:,0.07~0.63,P=0.005),without diabetes(OR=0.33,95%CI: 0.11~0.97,P=0.045),age less than 60 years(OR=0.39,95%CI: 0.13~0.53,P=0.048),no-smoking history(OR= 0.56,95%CI: 0.17~0.65,P=0.033)is protective factors for MCA M1 segment stenosis improvement;(2)Progressive group and non-progressive group(improved group plus stable group): Univariate analysis showed that the family history of stroke,diabetes,coronary heart disease,dyslipidemia,smoking history,without anticoagulation/antiplatelet therapy,without anti-atherosclerosis treatment and ipsilateral cerebrovascular disease recurrence events with statistical significance between the two groups;multivariate logistic regression analysis showed that the ipsilateral cerebrovascular events(OR=5.19,95%CI:,2.82~9.55,P < 0.001),diabetes(OR=3.38,95%CI: 1.80~6.36,P < 0.001),smoking history(OR=3.15,95%CI:,1.67~5.96,P < 0.001),without anticoagulation / antiplatelet therapy(OR=3.05,95%CI: 1.62~5.74,P=0.001),dyslipidemia(OR=2.89,95%CI: 1.48~5.64,P=0.002),without antiatherosclerosis treatment(OR=2.47,95%CI: 1.14~5.62,P=0.022)is independent risk factors for MCA M1 stenosis progression.Conclusions:1.The number of male patients is more than female patients in MCA M1 segment stenosis;The number of middle-elderly aged patients in MCA M1 stenosis is more than young group patients;After the same time,The number of the progressive group is more than stable group and improved group;2.age less than 60 years,without diabetes,no dyslipidemia,no smoking,no recurrence of ipsilateral cerebrovascular events,anticoagulation/antiplatelet therapy,anti-atherosclerosis treatment is protective factors for MCA M1 stenosis improvement;3.Diabetes,dyslipidemia,smoking history,ipsilateral cerebrovascular event recurrence,without anticoagulation/antiplatelet therapy,without anti-atherosclerosis treatment is independent risk factors for MCA M1 segment stenosis progressin.