脑梗死患者颈动脉颅外段不稳定斑块形成的危险因素

摘要

Objective To explore the risk factors of unstable atherosclerotic plaques on extracranial carotid arteries ( ECCA) in patients with cerebral infarction ( CI) . Methods According to the results of color-Doppler ultrasound examination, 205 CI patients with atherosclerotic plaques on ECCA were divided into unstable atherosclerotic plaque group (73 cases) and stable atherosclerotic plaque group (132 cases). Questionnaires were used to collect the information of the patients including age, gender, education level, living habits, disease history and family history. Meanwhile, blood biochemical indexes were measured. The risk factors of unstable atherosclerotic plaques on ECCA were analyzed by univariate non-conditional logistic regression analysis and multivariate stepwise non-conditional logistic regression analysis. Results Univariate analysis showed that the unstable atherosclerotic plaques on ECCA was negative correlation with education level and ratio of plasma apolipoprotein ( Apo) -A/Apo-B (all P < 0. 05 ) , meanwhile, which was positive correlation with smoking, combined with hypertension, diabetes and hyperlipemia, family histories of diabetes and stroke, the levels of fasting blood sugar, plasma viscosity, erythrocyte sedimentation rate, plasma fibrinogen ( P < 0. 05 -0.01). Multivariate stepwise non-conditional logistic regression analysis showed that diabetes history (OR=2.702, 95%CI: 1.183-6.175,X2 =5.559, P=0.018), hypertension history(OR = 2. 682, 95% CI: 1. 156 - 6. 226, X2 = 5. 275 , P = 0. 022) and smoking ( OR = 1. 371, 95% CI: 1.044-1.800,X2 =5. 142, P = 0.023) were the independent associated with unstable atherosclerotic plaques on ECCA in CI patients. Conclusion Diabetes, hypertension and smoking are the independent risk factors of unstable atherosclerotic plaques on ECCA in CI patients.%目的 探讨脑梗死(CI)患者颈动脉颅外段不稳定斑块形成的危险因素.方法 根据彩色多普勒超声仪检测结果将205例伴颈动脉颅外段斑块的CI患者分为不稳定斑块组(73例)及稳定斑块组( 132例)；对两组患者年龄、性别、文化程度、生活习惯、既往病史、家族史等进行问卷调查,并进行血液生化指标检测.以单因素及多因素非条件Logistic回归方法分析CI患者颈动脉颅外段不稳定斑块形成的危险因素.结果 单因素分析表明,颈动脉颅外段不稳定斑块形与患者的文化程度及血载脂蛋白(APO) -A/APO-B比值呈负相关(均P＜0.05)；与患者吸烟、伴有高血压病、糖尿病、高脂血症,以及糖尿病和卒中家族史、空腹血糖、血浆黏度、血沉、血浆纤维蛋白原水平正相关(P ＜0.05 ～0.01)；多因素Logistic回归分析表明,糖尿病(OR=2.702,95％ CI:1.183 ～6.175,x2=5.559,P=0.018)、高血压病(OR=2.682,95％ CI:1.156～6.226,x2=5.275,P=0.022)及吸烟(OR=1.371,95％ CI:1.044 ～1.800,x2=5.142,P=0.023)与CI患者颈动脉颅外段不稳定斑块形成的独立相关.结论 糖尿病、高血压病及吸烟是CI患者颈动脉颅外段不稳定斑块形成的独立危险因素.