Clinical Study Of Large Artry Atherosclerosis Minor Ischemic Stroke

Objective:To analyze the clinical features of Large artry atherosclerosis minor strokes,find factors with predictive value,instruct clinicians to develop individualized treatment plans for patients with large atherosclerotic strokes,so as to reduce the risk of recurrence,infarction and disability.Methods:Retrospective analysis of minor stroke patients who received standardized hospitalization in our hospital from January 2017 to May 2018.According to the TOAST classification method,50 patients with Large artry atherosclerosis minor strokes and 50 patients with Small artery occlusion minor stroke were selected.Patients were collected for risk factors(gender,age,history of hypertension,history of diabetes,history of hyperlipidemia,history of stroke,history of coronary heart disease,history of smoking,history of drinking),NIHSS scores,laboratory findings(triglyceride,low density lipoprotein,high density lipoprotein,fasting blood glucose,homocysteine,uric acid,creatinine,D-dimer),imaging findings(Single lesion,multiple lesions),Adverse outcome evaluation(deterioration of neurological function,stroke recurrence within 90 days of discharge),etc.,and differences between the two groups were compared.Statistically significant single factors were used as independent variables for multivariate logistic regression analysis.Multivariate logistic analysis was performed.Regression analysis of predictors of Large artry atherosclerosis minor stroke.Results:Analysis of risk factors data,the proportion of coronary heart disease in the large atherosclerotic small stroke group was higher than that in the small arterial occlusion group,the difference was statistically significant(P=0.009);the age,gender,and size of the large atherosclerotic small stroke group There was no significant difference in the proportion of hypertension,smoking history,drinking history,diabetes,hyperlipidemia,previous stroke history and small artery occlusion type of stroke group(P>0.05).Analysis of the scores showed that the gaze performance of the large atherosclerotic small stroke group was higher than that of the small artery occlusion group,the difference was statistically significant(P=0.025),while the visual field of the large atherosclerotic small stroke group,facialparalysis,The proportions of exercise,mutual aid,feeling,language,dysarthria,and neglect were not significantly different from those of small arteriovenous smear-type stroke group(P>0.05).According to the analysis of laboratory data,the ratio of low-density lipoprotein(3.69±0.79mmol/L)and blood homocysteine(17.16±9.40?mol/L)in the large atherosclerotic small stroke group was higher than that in the small artery occlusion group.The difference was statistically significant(P=0.018,P=0.006);triglyceride,high-density lipoprotein,fasting blood glucose,uric acid,D-dimer index and arteriolar occlusion in the large atherosclerotic small stroke group There was no significant difference in the small stroke group(P>0.05).Analysis of imaging data showed that the number of cases with multiple lesions in the large atherosclerotic small stroke group was significantly different from that in the small arteriovenous small stroke group(P=0.003).Analysis of adverse outcome data showed that the number of cases with adverse outcome of neurological deterioration in the large atherosclerotic small stroke group was significantly different from that in the small arteriovenous small stroke group(P=0.003).Statistically significant variables were included as independent variables in a multivariate logistic regression model.There were 6independent variables,including coronary heart disease history,gaze performance,low-density lipoprotein,homocysteine,and imaging findings of multiple lesions.Neurological deterioration.Multivariate logistic regression analysis showed multiple lesions(OR=5.393,95%CI : 1.282-22.689,P=0.022)and neurological deterioration(OR=15.294,95%CI:1.688-138.598,P=0.015)may be independent predictor of Large artry atherosclerosis minor stroke.Conclusion:Imaging findings of multiple lesions and clinical neurological deterioration may be independent predictors of Large artry atherosclerosis minor stroke.2.When a small stroke patient has a history of coronary heart disease;or clinical manifestations of gaze performance;or laboratory findings of high-low-density lipoprotein?high homocysteine;or imaging findings of multiple lesions;or neurological deterioration during hospitalization When the characteristics are such,the suggestion may be Large artry atherosclerosis minor stroke.