Clinical study on microembolic signals monitored by transcranial Doppler ultrasonography in acute ischemic stroke

Abstract

Objective To explore the correlation between microembolic signals (MES) in middle cerebral artery (MCA) and the occurrence of acute ischemic stroke and also evaluate the clinical effect of single and dual antiplatlet therapy.  Methods A total of 129 cases with acute ischemic stroke were tested by transcranial Doppler (TCD) ultrasonography to detect MES. Univariate and multivariate Logistic regression analysis were adopted to analyze and screen the positive risk factors for MES. Medication effects and prognosis were evaluated by treatment of aspirin and combination therapy of aspirin and clopidogrel. Results Among 129 patients, 42 patients (32.56% ) were detected MES positive. According to Logistic regression analysis, hyperlipidemia was the independent risk factor of patients with MES positive (OR = 0.335, 95%CI: 0.147-0.764; P = 0.009). After antiplatelet treatment, the disappearence rate of MES was higher in the dual-therapy treatment group than that in the monotherapy group ( χ² = 16.701, P = 0.000). The NIHSS score decreased significantly after 14 d of treatment in both groups (P = 0.000). The decrease of NIHSS score in dual-therapy group was more than that in monotherapy group (P = 0.025). It proves the effectiveness of antiplatelet treatment and the advantage of dual antiplatelet is superior to single antiplatelet.  Conclusions This study demonstrated that hyperlipidemia is the independent risk factor for MES positive detected by TCD and dual-therapy can inhibit the formation of MES and improve the recent prognosis.

DOI: 10.3969/j.issn.1672-6731.2016.06.009