Influencing factors of early compensation pathway formation in patients with cerebral infarction of internal carotid artery system
10.3969/j.issn.1672-5921.2019.04.004
- Author:
Xingyou HE
1
Author Information
1. Department of Neurology, First People's Hospital of Bijie
- Publication Type:Journal Article
- Keywords:
Carotid artery;
Carotid stenosis;
Cerebral infarction;
Collateral circulation;
Internal;
Prognosis
- From:
Chinese Journal of Cerebrovascular Diseases
2019;16(4):187-191
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influencing factors of early compensation pathway formation in patients with cerebral infarction of internal carotid artery system. Methods Eighty-eight consecutive patients with cerebral infarction in the internal carotid artery system admitted to the Department of Neurology,the First People's Hospital of Bijie, Guizhou Province from February 2016 to March 2018 were enrolled retrospectively. They were divided into low-open group (n =26) and high-open group (n= 62) according to the degree of collateral circulation opening. Hie differences of sex,age,smoking history,drinking history,hypertension, diabetes,hyperlipidemia,family history of cerebral infarction,degree of internal carotid artery stenosis, volume of cerebral infarction, Nalional Institutes of Health Stroke Scale (NIHSS) score in patients of the two groups were compared. Multivariate logistic regression analysis was used to screen the influencing factors of highly open collateral circulation. Outpatient follow-up was performed in the two groups of patients at 3 months after discharge. Their activities of daily living (ADL) scale scores were compared. Results (1) The proportion of hypertension, diabetes mellitus, and hyperlipidemia in the patients of the collateral circulation low-open group was higher than that in those of the collateral circulation high-open group,and the differences between groups were statistically significant (80.8% [21/26]vs. 58. 1% [36/ 62],57. 7% [15/26] vs. 14. 5% [9/62],96. 2% [25/26] vs. 53.2% [ 33/62 ], all P < 0. 05). There was no significant difference in the proportion of male,age ≥60,family history of cerebral infarction,smoking history,and drinking history between the groups (all P>0.05). (2) The NIHSS score and infarct volume of the collateral circulation low-open group were higher than those of the high-open group,and the proportion of severe stenosis of internal carotid artery was lower than that of the high-open group ([18 ±5] to. [10 ±3] ,89 [46, 145] mm3 vs. 35 [ 12,70] mm3,42. 3% (11/26) vs. 66. 1% (41/62) ;all P <0. 05 |. There was no significant difference in the time from onset to CTA (P > 0. 05). (3) With the collateral circulation high-open degree as the dependent variable,after variable screening,multivariate logistic regression analysis of hypertension .diabetes, and severe stenosis of internal carotid artery was performed. The results showed that diabetes was a risk factor for the collateral circulation high-open degree (OR, I. 361 ,95% CI 1. 277 - 2. 475 ,P = 0. 032) ,and severe internal carotid artery stenosis was a protective factor of collateral circulation low-open degree (OR, 0. 614,95% CI 0. 513 -0. 724, P - 0. 027). Hypertension was not associated with the degree of collateral circulation opening (P < 0.05). (4) The ADL scale score of the collateral circulation low-open group was lower than that of the high-open group, and the difference between the groups was statistically significant ( [ 51 ± 15 ] vs. [ 67 ± 18 ] , t = 3. 746, P < 0. 01 ) . Conclusion Cerebral infarction of internal carotid artery system patients with diabetes was not conducive to the establishment of early good collateral circulation, and with severe carotid stenosis was conducive to the establishment of good collateral circulation.
