Analysis Of Risk Factors Of Ischemic Cerebrovascular Disease And Correlation With Carotid Atherosclerosis

Background:With the improvement of living standards,the incidence of stroke is increasing year by year,which has caused a heavy burden to the whole world,where China accounts for the highest proportion.Atherosclerosis is closely related to the incidence of cerebral infarction.Moreover,unstable plaque affects the incidence of cerebral infarction,so early intervention of unstable plaque can reduce the incidence of cerebral infarction.Atherosclerosis is a complex process,involving many biomarkers(such as lipoprotein phospholipase A2(lp-PLA2),uric acid,hypersensitive C-reactive protein(hs-CRP),etc).These biomarkers are not only associated with atherosclerosis,but also as a risk factor for the onset of cerebral infarction.Because of diet,habits and so on are different in particular regions,some risk factors of cerebral infarction may have regional differences.So the risk factors of cerebral infarction in Kaifeng region are discussed,especially whether the relationship has regional characteristics between cerebrovascular disease risk factors and atherosclerosis.Objective:1.Discuss the risk factors of ischemic cerebrovascular disease.2.Discuss the correlation between risk factors of cerebral vascular disease and carotid atherosclerosis.Methods:63 patients with acute cerebral infarction and 21 patients with transient ischemic attack were selected from December 2018 to December 2019 in the Department of Neurology,Huaihe Hospital Henan University.At the same time,42 patients were selected as the normal control group.The age,sex,the history of hypertension,the history of diabetes,the history of coronary heart disease,the history of smoking and drinking,neutrophil to lymphocyte ratio(NIR),red blood cell number(RBC),hemoglobin(Hb),platelet number(PLT),mean platelet volume,fibrinogen(FIB),D-dimer,uric acid(UA),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),homocysteine(HCY),glycosylated hemoglobin,potassium,glycosylated hemoglobin,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),plasma phospholipase A2(Lp-PLA2),Color Doppler ultrasonography of neck vessels and MR examination of the head were recorded.At the same time,it was divided into acute cerebral infarction(ACI)group and transient ischemic attack(TIA)group according to the results of cranial MR examination and clinical symptoms.The changes of arterial intima in the control group and ischemic cerebrovascular disease(ICD)group were compared and analyzed according to the degree of cervical vascular lesion and plaque stability.We study the relationship between changes of carotid arterial intima and other risk factors such as Lp-PLA2,LDL,ESR,C-reactive protein,homocysteine,fibrinogen,and ESR.Results:1.A total of 21 TIA patients selected,which included 11 male patients(52.4%)and 10 female patients(47.6%).The TIA group showed significant difference in uric acid(P =0.000),low density lipoprotein(LDL)(P =0.048),diabetes history(P =0.007),C-reactive protein(P =0.048),erythrocyte sedimentation rate(ESR)(P =0.027),and homocysteine(HCY)(P =0.007)compared with the normal control group.Multivariate analysis suggested uric acid(OR =3.5,95%IC 1.034-11.899,P =0.027)and homocysteine(HCY)(OR =4.247,95%IC 1.331-13.551,P =0.015)were independent risk factors for transient ischemic attack(TIA).2.A total of 63 ACT patients selected,included 42 males(66.7%)and 21 females(33.3%).Single factor analysis showed that age(P =0.032),history of hypertension(P =0.002),history of diabetes(P =0.026),uric acid(P =0.000),glycerin trilaurate(P =0.000),low density lipoprotein(LDL)(P=0.000),erythrocyte sedimentation rate(ESR)(P =0.000),plasma phospholipase A2(P =0.000),fibrinogen(FIB)(P =0.004),C-reactive protein(CRP)(P =0.000),and homocysteine(P =0.000)had significant difference compared with control group.Moreover,these factors,which were involved in ACI group,were much higher than control group.Multivariate analysis suggested that LDL(OR =3.293,95%IC 3.293-8.261,P =0.011),Lp-PLA2(OR =2.753,95%IC 1.127-6.728,P =0.026),HCY(OR =2.514,95%IC 1.023-6.182,P =0.045)were independent risk factors for acute cerebral infarction(ACI).3.There were significant differences between normal,moderate and elevated blood Lp-PLA2 levels in the ICD group and control group(P <0.05).4.The level of blood Lp-LPA2 in the ICD group was positively correlated with the level of C-reactive protein(P <0.05),but erythrocyte sedimentation rate(ESR),fibrinogen,low density lipoprotein(LDL),uric acid(UA),homocysteine(HCY)had little connection with Lp-PLA2.5.The composition ratio of the carotid artery normal group,wall thickening group and plaque group in the control group and ICD group were different(P <0.05).And the proportion of stable plaque and unstable plaque also were different in two groups(P <0.05).6.The level of Lp-PLA2,FIB,UA in the three groups were significantly different(P <0.05),but the level of LDL,CRP,HCY,ESR in the three groups had no significant difference(P >0.05).7.The level of blood Lp-PLA2,FIB,UA increased gradually with the aggravation of carotid vascular lesions.That is,these factors had the highest level in the plaque group.The difference was significant(P <0.05),and the level of these factors in the unstable plaque group were higher than the stable plaque group(P <0.05).LDL,CRP,HCY,ESR level had no significant difference with progressing of carotid vascular intima disease.Conclusions:1.Detection of risk factors of ischemic cerebrovascular disease plays a positive role in predicting stroke events.2.Lp-PLA2 is associated with instability of carotid plaques and affects the likelihood of ischemic cerebrovascular events.