颈动脉粥样斑块形成的影响因素研究

摘要

目的 探讨颈动脉粥样斑块形成的影响因素.方法 选取2016年4—12月于北京大学第三医院接受体检的受检者372例,依据颈动脉内膜中层厚度(IMT)将372例受检者分为斑块形成组(110例)和无斑块形成组(262例).收集患者一般资料,检测颈总动脉IMT,并测定补体C1q水平和生化指标,采用多因素Logistic回归分析颈动脉斑块形成的影响因素.结果 两组性别、年龄、吸烟、规律运动、高血压病史、糖尿病病史、服用降压药、服用降脂药、服用降糖药、收缩压、舒张压、体质指数(BMI)、补体C1q、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素氮(BUN)、尿酸(UA)、肌酐(Cr)、三酰甘油(TG)、空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)、C反应蛋白(CRP)、糖化血红蛋白(HbA1c)、同型半胱氨酸(Hcy)水平比较,差异均有统计学意义(P<0.05).双侧IMT与补体C1q水平无直线相关关系(rs=-0.14,P=0.052).多因素Logistic回归分析结果显示,年龄〔OR=1.11,95%CI(1.07,1.16)〕、规律运动〔OR=2.88,95%CI(1.37,6.22)〕、服用降糖药〔OR=0.15, 95%CI(0.03,0.59)〕、舒张压〔OR=1.05,95%CI(1.02,1.09)〕、Cr〔OR=1.03,95%CI(1.00,1.06)〕、TG〔OR=1.49, 95%CI(1.01,2.22)〕是颈动脉斑块形成的影响因素(P<0.05).结论 颈动脉粥样斑块的形成与年龄、规律运动、糖尿病服药情况、血压和血脂水平有关,对临床预防颈动脉粥样斑块形成具有重要的参考价值.%Objective To investigate the influencing factors of carotid atheromatous plaque(CAP) formation. Methods The enrolled 372 participants were part of the individuals undergoing medical examination in Peking University Third Hospital from April to December 2016.We collected their clinical data,common carotid artery intima-media thickness(IMT) detected by color Doppler flow imaging〔110 were found with CAP (CAP group) and 262 without (non-CAP group)〕and measurement results of complement C1q and biochemical parameters.A multivariate Logistic regression analysis was performed to analyze the influencing factors of CAP formation.Results Two groups had significant differences in the distribution of sex, age,smoking,regular exercise,history of hypertension and diabetes,use of antihypertensive drugs,lipid-lowering drugs and hypoglycemic agents,levels of systolic and diastolic blood pressure,body mass index,complement C1q,alanine aminotransferase,aspartate aminotransferase,urea nitrogen,uric acid,creatinine (Cr),triglyceride (TG),fasting blood glucose,high-density lipoprotein cholesterol,C-reactive protein,glycosylated hemoglobin,and homocysteine (P<0.05). There was no correlation between bilateral IMT and complement C1q levels (rs=-0.14,P=0.052).Multivariate Logistic regression analysis showed that age〔OR=1.11,95%CI (1.07,1.16)〕,regular exercise〔OR=2.88,95%CI (1.37, 6.22)〕,use of hypoglycemic agents〔OR=0.15,95%CI (0.03,0.59)〕,diastolic blood pressure〔OR=1.05,95%CI (1.02, 1.09)〕,Cr〔OR=1.03,95%CI (1.00,1.06)〕,and TG〔OR=1.49,95%CI (1.01,2.22)〕were the influencing factors of CAP formation (P<0.05).Conclusion CAP formation was found to be correlated with age,regular exercise,use of hypoglycemic agents,levels of blood pressure and blood lipid.This result provides an important reference for clinical prevention of CAP formation.