天津地区脑卒中人群颈动脉内中膜厚度与斑块积分的相关性研究

摘要

目的：探讨天津地区脑卒中人群颈动脉粥样硬化状况，评价颈动脉内中膜厚度（IMT）及斑块积分的年龄分布特点，并对其相关危险因素进行研究。方法选取天津市地区50岁以上长住人口，以问卷方式筛选出脑卒中患者1083人，其中男性568例（52.4%），女性515（47.6%），平均年龄为（66.03±9.05）岁。按年龄进行分组，所有入选人群进行病史询问，体检及血脂、血糖测定，应用彩色多普勒超声诊断仪检测其双侧颈动脉IMT及斑块积分情况，分析颈动脉粥样硬化的年龄分布情况及其与相关危险因素之间的关系。结果（1）51～60岁、61～70岁及70岁以上组IMT分别为（0.85±0.18）、（0.95±0.44）及（1.10±0.41）mm；斑块积分为（5.88±3.77）、（6.77±4.99）及（8.44±6.49） mm。均呈70岁以上组＞61～70岁组＞51～60岁组，差异具有统计学意义（P＜0.05）。（2）颈动脉粥样硬化相关因素的单因素及多因素Logistic回归分析，年龄、吸烟史、高血压、糖尿病、血清甘油三酯（TG）为IMT增厚及斑块形成的独立危险因素（P＜0.05）。结论脑卒中患者颈动脉IMT及斑块积分随年龄增长呈上升趋势，年龄、吸烟史、高血压、糖尿病、TG，为IMT增厚及斑块形成的危险因素，颈动脉的超声检测及危险因素的预防对脑卒中防治具有重要临床意义。%Objective To investigate the state of carotid atherosclerosis in stroke patients in Tianjin district,and to explore the age distribution and risk factors of intima-media thickness(IMT) and plaques score.Methods A total of 1 083 stroke patients were selected from permanent population aged over 50 in Tianjin, of which there were 568 males (52.4%) and 515 females(47.6%), The average age of samples was (66.03±9.05). Patients were divided into different groups according to age. All examples were investigated, including patients. medical history, physical examination, blood lipids and blood sugar. Intima-media thickness and plaques score were collected for patients by color Doppler Ultrasound Diagnosis Apparatus. Then, the age distribution and risk factors of IMT and plaques score were analyzed.Results(1) The IMT of 51~60, 61~70, over 70 age group were (0.85±0.18), (0.95±0.44) and (1.10±0.41) respectively, and the plaques score of the three groups were (5.88±3.77), (6.77±4.99) and (8.44±6.49)mm respectively. There was significantly difference of IMT between the three groups (P<0.05), and 51 to 60 age group were lower than 61 to 70 age group and 61 to 70 age group were lower than over 70 age group. (2) The results of univariate analysis and multivariate logistic regression for risk factors of carotid atherosclerosis indicated that, age, smoking history, hypertension, diabetes, triglyceride (TG) were risk factors of IMT and plaque formation (P<0.05).Conclusion IMT and plaques score increase with age in stroke patients. Age, smoking history, hypertension, diabetes, TG were risk factors of IMT and plaque formation. The carotid artery ultrasound and the prevention of risk factors have an important clinical role in the prevention and control of stroke.