An Analysis Of Corticosteroids Therapy In Ischemic Stroke Patients With High Resolution Magnetic Resonance Imaging Showing Concentric Concentration Of Intracranial Vascular Stenosis

Objective: To observe the clinical effects of conventional drug therapy versus conventional drug therapy plus corticosteroids therapy and to investigate the etiology of intracranial vascular concentric concentration in ischemic stroke patients with high resolution magnetic resonance imaging showing intracranial vascular concentric concentration.Methods:1.Patients with ischemic stroke who were admitted to the department of neurology of the second hospital of Hebei medical university from September 2017 to October 2019 confirmed by high resolution magnetic concentration in intracranial vascular concentric stenosis were collected.2.The patients were divided into the conventional drug treatment group and conventional drug therapy plus the corticosteroids treatment group.The basic risk factors of concentric concentration and ecentric concentration were compared.The recurrence rate of cerebrovascular diseases(cerebral infarction,TIA and intracranial hemorrhage),the change of vascular concentration and the patients' improved modify Rankin score before and after treatment were compared between conventional drug therapy plus the conventional treatment group and the corticosteroids treatment group.Results: 1.148 cases of intracranial artery stenosis were screened.63 cases of concentric concentration and 85 cases of ecentric concentration were detected by high resolution magnetic,and the age of the two groups of risk factors in the concentric concentration group was relatively small,and the white blood cell count,neutrophils count and homocysteine were higher than that in the ecentric concentration group,with statistical differences(P<0.05);the prevalence of hypertension in patients with eccentric concentration is higher than that of concentric concentration.2.Eighteen patients in the concentric concentration group received conventional drug therapy plus corticosteroids therapy,45 patients received conventional therapy.2 patients in the conventional drug therapy plus corticosteroids therapy group(11.1%)had recurrent cerebral infarction;and 4 patients in the conventional treatment group(8.9%)had recurrent cerebrovascular disease,including 3 patients with cerebral infarction and 1 patient with complicated subdural hemorrhage.There was no statistical difference between the two groups(P=1.000).3.Before and after treatment,the m RS score of the two groups reduced significantly(P=0.000),and the patients improvement of m RS in the conventional drug therapy plus corticosteroids group was better than that in the conventional treatment group(P=0.005).4.A complete follow-up was obtained in 27 cases with high resolution magnetic imaging,14 cases in the conventional drug therapy plus corticosteroids group and 13 cases in the conventional treatment group.There was no statistical difference between the two groups in the improvement of vascular concentration.Conclusions:1.The number of white blood cells,neutrophils,homocysteine biochemical index in patients with intracranial vascular concentric concentration increased compared with those with ecentric concentration and the age of onset in intracranial vascular concentric concentration group was significantly lower than that of the ecentric concentration group.2.Hypertension is a risk factor for ecentric concentration of intracranial blood vessels;3.In vascular concentric concentration group,the ability of daily life improve significantly in conventional treatment group and conventional drug therapy plus corticosteroids group,but conventional drug therapy plus corticosteroids therapy is more significant.4.The effect of low dose and short course of treatment on the degree of intracranial vascular concentric concentration,the change of vascular lumen stenosis and the recurrence of stroke was not better than the conventional drug treatment.5.Low dose and short course of conventional drug therapy plus corticosteroids treatment can reduce the white blood cells,neutrophils and hs-CRP,but there is no significant difference.