BACKGROUND: Cerebral infarction, formerly known as ischemic stroke, refers to localized ischemic necrosis or softening caused by disorders of blood supply to the brain, ischemia, or hypoxia. Cerebral infarction is characterized by high mortality and morbidity. Therefore, early and accurate diagnosis of cerebral infarction is of great significance to the selection of treatment and prognosis of patients. Electrocardiogram (ECG) is the traditional method for diagnosing myocardial infarction. However, ECG diagnosis of myocardial infarction based on electrophysiological manifestations of cardiac electrostimulation can only indirectly reflect the anatomical lesions, and can not diagnose the lesions in special parts of the heart, so there are diagnostic limitations, there will be certain missed diagnosis and misdiagnosis.
OBJECTIVE: Our study aimed to assess the effect of carotid Doppler ultrasound combined with cysteine, D dimer, and other indexes in the clinical diagnosis of cerebral infarction, in order to provide effective basis for early diagnosis and treatment of cerebral infarction patients.
DESIGN: This study was a retrospective study.
SETTING: This study was carried out in First Affiliated Hospital, Anhui University of Science and Technology (Huainan First People's Hospital) from November 2020 to December 2022.
PARTICIPANTS: A total of 40 patients with cerebral infarction were selected as the observation group (OG). At the same time, 40 healthy people who underwent physical examinations were selected as the control group (CG). There were 21 males and 19 females in the OG. The age ranged from 59 to 76 years, with an average of (67.11±0.23) years. There were 23 males and 17 females in the CG. The age ranged from 58 to 77 years, with an average of (68.04±0.35) years.
INTERVENTIONS: Both groups of subjects underwent carotid Doppler ultrasound examination to observe the number of carotid plaque formation, the carotid artery intimal thickness and the lumen diameter. Besides, serum homocysteine (Hcy) and cystatin C (Cys-C) levels of the subjects were detected by an automatic biochemical analyzer and supporting reagents. The serum high sensitivity C reactive protein (hsCRP) levels of the two groups were detected by immune turbidimetry. The plasma levels of D-dimer (D-D) and fibrinogen (FIB) were detected by immunoturbidimetric method. Receiver operating characteristic (ROC) curve was implemented to analyze the value of Color Carotid Doppler ultrasound combined with Hcy, Cys-C, hsCRP, D-D and FIB detection in diagnosing cerebral infarction.
OUTCOME MEASURES: (1) Carotid Doppler ultrasound can observe cardiac morphological changes from multiple angles and planes, and diagnose myocardial infarction according to the changes of ventricular wall structure caused by myocardial ischemia. It has the advantages of simple operation and high image quality. (2) The hemodynamic parameters of the bilateral common carotid artery and internal carotid artery, (3) Serum Hcy, Cys-C, and hsCRP levels, as well as plasma levels of D-D and FIB. Hcy is an independent risk factor for cardiovascular and cerebrovascular diseases, and the Hcy level is directly related to the pre-onset of cerebral infarction patients. Cys-C is an ideal endogenous marker to reflect the change of glomerular filtration rate. In recent years, it has been found that the interaction of Cys-C, Hcy and cathepsin is involved in the pathological process of cardiovascular diseases such as atherosclerosis, aneurysm and myocardial infarction. hsCRP can reflect left ventricular function, myocardial injury, inflammation and other conditions, which is helpful to evaluate the condition of cerebral infarction patients. D-D can reflect the coagulation function of the body, and its high expression can indicate that the body is in a state of hypercoagulation, accompanied by secondary hyperfibrinolysis, and is often used in the clinical diagnosis of cerebral infarction. FIB is an important factor contributing to atherosclerosis and plays an important role in the occurrence and development of cerebral infarction. (4) ROC curve results.
RESULTS: The number of carotid plaque formation in the OG was significantly higher compared to the CG (P < .05). The carotid artery intimal thickness in the OG was relatively elevated relative to the CG (P < .05). The lumen diameter was smaller in the OG compared to the CG (P < .05). The peak systolic velocity and end-diastolic velocity of the left and right common carotid artery and the left and right internal carotid artery in the OG declined compared to the CG, and the resistance index of the left and right common carotid artery and the left and right internal carotid artery in the OG was elevated compared to the CG (P < .05). The serum levels of Hcy, Cys-C, and hsCRP, as well as plasma levels of D-D and FIB in the OG, were elevated compared to the CG (<.05). The sensitivity and specificity of Color Carotid Doppler ultrasound combined with Hcy, Cys-C, hsCRP, D-D and FIB in the diagnosis of AMI were 0.919 and 0.817 respectively, significantly higher than that predicted by alone (P < .001).
CONCLUSIONS: Carotid Doppler ultrasound combined with cysteine, D dimer, and other indexes played an important role in the clinical diagnosis of cerebral infarction, which was worthy of promotion. Our experimental results provide an important basis for the clinical scientific application of Carotid Doppler ultrasound and myocardial marker detection, especially for those AMI patients with no abnormal changes in ECG and no obvious clinical symptoms, it can realize early diagnosis and timely treatment, and reduce the mortality of AMI.