期刊文献+

缺血性卒中患者颈动脉粥样硬化斑块表面形态影响因素分析 被引量:14

Influencing Factors of the Surface Morphology of Carotid Atherosclerotic Plaque in Patients with Ischemic Stroke
下载PDF
导出
摘要 目的颈动脉粥样硬化斑块被认为是导致急性脑血管事件可预测的影响因素,本研究探讨缺血性卒中患者颈动脉粥样硬化斑块表面形态的影响因素。方法选择2013年1—8月在安阳市人民医院神经内科住院治疗的缺血性卒中患者260例,采用彩色B超诊断仪行颈部血管超声检测,取每例患者直径最大的斑块并根据超声显示斑块表面形态的不同,分为:光滑型、不规则型、溃疡型3种类型,并记录性别、年龄、病程、吸烟史、高血压、高脂血症、糖尿病、既往是否有缺血性卒中病史及责任血管。采用多因素Logistic回归分析不同类型斑块的影响因素。结果多因素Logistic回归分析结果显示,高脂血症〔OR=0.338,95%CI(0.183,0.625),P=0.001〕与光滑型斑块有回归关系;高脂血症〔OR=0.469,95%CI(0.231,0.953),P=0.036〕与不规则型斑块有回归关系;高血压〔OR=0.443,95%CI(0.214,0.919),P=0.029〕、高脂血症〔OR=0.427,95%CI(0.192,0.953),P=0.038〕、糖尿病〔OR=2.628,95%CI(1.178,5.866),P=0.018〕与溃疡型斑块有回归关系。结论高血压是溃疡型斑块独立的影响因素,而高脂血症是各种类型斑块的独立影响因素,不同类型表面斑块的影响因素有共同影响因素,不同斑块表面形态也有各自独立的影响因素。 ObjectiveComplicated(irregularorulcerated)carotidplaqueisregardedasanindependentriskfactor of ischemic cerebrovascular disease .This study is to analyze the factors influencing the surface morphology of carotid atherosclerotic plaqueinpatientswithischemicstroke.Methods 260patientswithischemicstrokeadmittedtothedepartmentofneurologyof Anyang People′s Hospital from January to August in 2013 were selected.Carotid atherosclerotic plaque were detected by color Doppler ultrasound.The largest plaque of each patient was selected and in accordance with the surface morphology , the plaques were classified as smooth, irregular and ulcerated.The patients′sex, age, disease course, smoking history, hypertension, hyper-lipemia, diabetes and history of ischemic stroke were recorded .Multivariate Logistic regression analysis was used to analyze the in-fluencing factors for plaques .Results Multivariate Logistic regression analysis showed that hyperlipemia 〔OR=0.338, 95%CI (0.183, 0.625), P=0.001〕 was risk factor for smooth plaques; Hyperlipemia 〔OR=0.469, 95%CI (0.231, 0.953), P=0.036〕 was risk factor for irregular plaques; Hypertension 〔OR=0.443, 95%CI (0.214, 0.919), P=0.029〕, hyperlipemia〔OR=0.427, 95%CI (0.192, 0.953), P=0.038〕 and diabetes 〔OR=2.628, 95%CI (1.178, 5.866), P=0.018〕 were risk factors for ulcerated plaques .Conclusion Hypertension is independent risk factor for ulcerated plaques and hyperlipemia is independent risk factor for all plaques .Different types of plaques may have common risk factors and different types of plaque mor-phology have their own risk factors .
作者 袁静 张向东
出处 《中国全科医学》 CAS CSCD 北大核心 2014年第21期2426-2430,共5页 Chinese General Practice
关键词 卒中 颈动脉 动脉粥样硬化 影响因素 Stroke Carotidarteries Atherosclerosis Influencefactors
  • 相关文献

参考文献24

  • 1Nichols WW, Pepine CJ, O'Rourke MF. Carotid -artery intima and media thickness as a risk factor for myocardial infarction and stroke [J]. New Eng J Med, 1999, 340 (22) : 1762 -1763.
  • 2Bothwell PM, Gibson R, Warlow CP. Interrelation between plaque sur- face morphology and degree of stenosis on carotid angiogTams and the risk of ischemic stroke in patients with symptomatic carotid stenosis. On behalf of the European Carotid Surgery Trialists' Collaborative Group [ J ]. Stroke, 2000, 31 (3): 615-621.
  • 3Eliasziw M, Stroifier JY, Fox AJ, et al. Significance of plaque ulceration in symptomatic patients with high - grade carotid stenosis. North Ameri- can Symptomatic Carotid Endarterectomy Trial [ J ] . Stroke, 1994, 25 (2) : 304 -308.
  • 4各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380. 被引量:33037
  • 5de Weert TT, Cretier S, Groen HC, et al. Atherosclerotic plaque sur- face morphology in the carotid bifurcation assessed with muhidetector computed tomography angiography [ J ]. Stroke, 2009, 40 ( 4 ) : 1334 - 1340.
  • 6于林,郝熙枝,郝建芳,武运.脑卒中患者颈动脉颅外段不稳定斑块相关危险因素研究[J].实用心脑肺血管病杂志,2010,18(9):1217-1218. 被引量:5
  • 7Homburg PJ, Rozie S, van Gils M J, et al. Association between carotid artery plaque ulceration and plaque composition evaluated with multide- tector CT angiography [J]. Stroke, 2011, 42 (2): 367-372.
  • 8Wechsler LR. Ulceration and carotid artery disease [ J]. Stroke, 1988, 19 (5): 650-653.
  • 9Liu Z, Lu F, Pan H, et al. Correlation of peripheral Th17 cells and Th17 - associated cytokines to the severity of carotid artery plaque and its clinical implication [J]. Atherosclerosis, 2012, 221 (1): 232-241.
  • 10Lee KB, Budoff M J, Zavodni A, et al. Coronary artery calcium is as- sociated with degree of stenosis and surface irregularity of carotid artery [J]. Atherosclerosis, 2012, 223 (1): 160-165.

二级参考文献129

共引文献33153

同被引文献109

  • 1成珍珍,王建华,丁桂春.2型糖尿病患者颈动脉粥样硬化的超声评估和临床相关危险因素分析[J].中华医学超声杂志(电子版),2013,10(6). 被引量:24
  • 2刘秋云,陈明,王超,江梅,傅晓红,刘连勇,丁晓静.急性缺血性脑卒中患者颈动脉窦部斑块周围壁面剪应力的空间分布[J].肿瘤影像学,2013,22(1):1-5. 被引量:1
  • 3潘瑞华.颈动脉斑块稳定性与青中年脑梗死发病关系探讨[J].中国实用神经疾病杂志,2007,10(2):67-69. 被引量:19
  • 4单梅芳,黄怀宇,顾承志.安体舒通对实验兔动脉粥样硬化斑块的保护作用[J].中国微循环,2007,11(4):250-252. 被引量:2
  • 5邓连桂,王晓波.彩色多普勒超声对缺血性脑血管病患者颈动脉的检查价值[J].上海医学影像,2011;20(2):155-7.
  • 6Eckstein HH. Evidence-based management of carotid stenosis: recommendations from international guidelines [J]. J Cardio vase Surg(Torino) ,2012,53(1 Suppl 1) :3-13.
  • 7Crouse JR, Grobbee DE, () leary dH, et al. Carotid intima- media thickness in low-risk individuals with asymptomatic ath erosclerosis:baseline data from the METEOR study[J]. Curr Med Res Opin, 2007,23 (3) : 641-648.
  • 8Moustafa RR, Izquierdo-Garcia D, Fryer TD, et al. Carotid plaque inflammation is associated with cerebral microembo- lism in patients with recent transient ischemic attack or stroke : a pilot study[J]. Circ Cardiovasc Imaging, 2010,3 (5) : 536-541.
  • 9Carotid Plaque Area and Intima-Media Thickness in Prediction of First-Ever Ischemic Stroke: A 10-Year Follow-Up of 6584 Men and Women: The Troms? Study(J)Stroke . 2011 (4)
  • 10Eric Y. Yang,Lloyd Chambless,A. Richey Sharrett,Salim S. Virani,Xiaoxi Liu,Zhengzheng Tang,Eric Boerwinkle,Christie M. Ballantyne,Vijay Nambi.??Carotid Arterial Wall Characteristics Are Associated With Incident Ischemic Stroke But Not Coronary Heart Disease in the Atherosclerosis Risk in Communities (ARIC) Study(J)Stroke . 2012 (1)

引证文献14

二级引证文献92

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部