Clinical study on the effect of inflammation on severe stenosis or occlusion of intracranial and extracranial arteries

Abstract

Objective To screen the risk factors for severe stenosis or occlusion of intracranial and extracranial arteries, and to explore the influence of inflammation on the location of intracranial and extracranial arteries stenosis or occlusion. Methods A total of 100 patients with acute ischemic stroke of large artery atherosclerosis (LAA) type from September 2018 to April 2019 were enrolled. Serum high sensitive C⁃reactive protein (hs⁃CRP) was measured by grains strengthen immunoturbidimetry. According to the standard of North American Symptomatic Carotid Endarterectomy Trial (NASCET), the patients were divided into severe stenosis/occlusion group and control group and then further divided into different subgroups. Univariate and multivariate backward Logistic regression analysis was used to screen the risk factors for intracranial and extracranial arteries stenosis or occlusion. Results Logistic regression analysis showed that diabetes mellitus (OR=11.092, 95%CI: 2.288-53.774; P=0.003) and serum hs⁃CRP (OR= 1.553,95%CI:1.184-2.036; P=0.001) were risk factors for severe stenosis or occlusion of intracranial and extracranial arteries in patients with acute ischemic stroke. Subgroup analysis showed that there was no significant difference in serum hs⁃CRP in patients of intracranial artery subgroup (n=49), extracranial artery subgroup (n=11) and intracranial combined with extracranial artery subgroup (n=12; H=0.652, P= 0.722); anterior circulation subgroup (n=37), posterior circulation subgroup (n=18) and anterior circulation combined with posterior circulation subgroup (n=17; H=0.283, P=0.868); single vessel subgroup (n=41) and multi⁃vessel subgroup (n=31; Z=⁃0.530, P=0.596). There was no significant difference in serumhs⁃CRP in patients with different responsibility vascular stenosis/occlusion [middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), basilar artery (BA), intracranial segment of vertebral artery (VA), intracranial segment of internal carotid artery (ICA), extracranial segment of carotid artery, extracranial segment of VA and subclavian artery (SA); χ2=2.628, P=0.917]. Conclusions hs⁃CRP may be an inflammatory predictor of cerebral artery stenosis or occlusion. But inflammation has no selective effect on the distribution and numbers of the cerebral vascular stenosis and may have similar effects on different cerebral arteries.

DOI：10.3969/j.issn.1672⁃6731.2020.09.008