摘要
目的分析急性缺血性卒中（AIS）患者颈动脉斑块的分布特点,探讨颈动脉易损性斑块的危险因素。方法收集兰州大学第二医院神经内科2014年3月-2015年2月收治的588例AIS患者及性别、年龄匹配的630例非脑卒中患者的临床资料,分析两组颈动脉斑块的分布规律;根据颈部血管超声检查结果将AIS患者分为无斑块组（247例）、稳定斑块组（93例）、易损斑块组（248例）,比较3组患者的临床资料,并进行多因素logistic回归分析以确认颈动脉易损性斑块的独立危险因素。结果 AIS组和对照组颈动脉斑块检出率分别为57.99%、50.95%,其中易损性斑块检出率分别为42.18%、33.81%,AIS组颈动脉斑块和易损性斑块检出率均高于对照组,差异有统计学意义（P〈0.05）。颈动脉不同斑块组间年龄、男性比例、高血压、糖尿病及收缩压比较差异有统计学意义（P〈0.05）,多因素logistic回归分析显示年龄（OR=1.043,95%CI 1.027～1.061,P=0.000）、男性（OR=1.973,95%CI 1.377～2.828,P=0.000）、糖尿病（OR=1.454,95%CI1.004～2.106,P=0.047）、收缩压（OR=1.011,95%CI 1.002～1.020,P=0.016）是AIS患者颈动脉易损性斑块的独立危险因素。结论颈动脉易损性斑块破裂、脱落继发栓塞可导致AIS的发生;年龄、性别、糖尿病和收缩压是AIS患者颈动脉易损性斑块的独立危险因素。
Objective To analyze the distribution characteristics of carotid plaque, and explore the risk factors for carotid vulnerable plaque in patients with acute ischemic stroke （AIS）. Methods The clinical data were collected from 588 patients with AIS and 630 patients without AIS matched in gender and age admitted to the Department of Neurology, Second Hospital of Lanzhou University from Mar. 2014 to Feb. 2015. The distribution characteristics of carotid plaque between the two groups were analyzed. All AIS patients were classified as non-plaque group （n=247）, stable plaque group （n=93） and vulnerable plaque group （n=248） according to the carotid ultrasonography results. The clinical data were compared among the different three groups, and multivariate logistic regression analysis was performed to identify the independent risk factors for carotid vulnerable plaque in AIS patients. Results The detection rates of carotid plaque in AIS group and control group were 57.99% and 50.95%, and the detection rates of vulnerable plaque in the two groups were 42.18% and 33.81%, respectively~ the detection rates of both carotid plaque and vulnerable plaque were statistically higher in AIS group than in control group （P〈0.05）. The age, gender, history of hypertension, diabetes and the level of systolic blood pressure among the three groups showed statistically significant differences （P〈0.0S）; the multivariate logistic regression analysis revealed that age （OR----1.043, 95%CI 1.027-1.061, P=0.000）, male gender （0R=1.973, 95%CI 1.377-2.828, P=0.000）, diabetes （0R=1.454, 95%CI 1.004-2.106, P=0.047） and systolic blood pressure （OR=I.011, 95%CI 1.002-1.020, P=0.016） were the independent risk factors for carotid vulnerable plaque in patients with AIS. Conclusions The embolism accompanied by carotid vulnerable plaque rupture or abscission may lead to the occurrence of AIS; the age, gender, diabetes and systolic blood pressure are the independent risk factors for carotid vulnerable plaque in patients with AIS.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2016年第9期740-745,共6页
Medical Journal of Chinese People's Liberation Army
基金
兰州市科技计划项目(2011-1-134)~~
