脑卒中高危人群颈动脉超声异常检出率及其影响因素分析

摘要:目的　研究宁波市江东区脑卒中高危人群颈动脉超声检查情况并探索其影响因素。方法　2013年5-7月在宁波市江东区按照统一标准筛查出脑卒中高危者610例，根据问卷调查、体格检查、实验室检查及颈部血管彩色超声检查结果等进行分析。结果　610例高危人群中检出颈动脉彩超检查异常253例（检出率为41.48%），其颈动脉中内膜增厚99例（检出率为16.23%），颈动脉斑块190例（检出率为31.15%），颈动脉狭窄139例（检出率为22.79%）。颈动脉异常检出率随年龄增长升高，吸烟者检出率也升高。多因素分析发现高龄、教育程度高、饮酒、脑卒中或短暂脑缺血发作史、血糖和LDL-C是危险因素，体育锻炼和HDL-C为保护因素。血糖作为危险因素主要存在男性中（OR＝1.31，95%CI:1.11～1.55），在女性中无影响（OR＝1.00，95%CI:0.79～1.27）；HDL-C作为保护因素主要存在女性中（OR＝0.13，95%CI:0.05～0.35），在男性中无影响（OR＝1.15，95%CI:0.39～3.37）。结论　脑卒中高危人群颈动脉超声检查异常检出率较高，高龄、教育程度高、饮酒、脑卒中或短暂脑缺血发作史、血糖和LDL-C是危险因素，体育锻炼和HDL-C为保护因素。

Abnormal detection rate of ultrasound in carotid and its influencing factor among high-risk groups of stroke

Abstract: Objective To study the inspection status of ultrasonic in carotid and its influencing factors among high-risk groups of stroke in Jiangdong District, Ningbo. Methods Between May and July in 2013, a total of 610 high-risk groups of stroke were screened out by unified standard in Jiangdong District, Ningbo. We carried out the analysis according to the questionnaire survey, physical examinations, laboratory tests and carotid color ultrasonic inspection. Results Among the 610 high-risk cases of stroke, 253 cases (41.48%) were checked out with abnormal carotid by color ultrasonic inspection, among which were 99 cases (16.23%) with thicken carotid media-intima tunica, 190 cases (31.15%) with carotid plaque and 139 cases (22.79%) with carotid stenosis. The abnormal rate of males was higher than that among females, and the abnormal rate increased with age. The abnormal rate of smokers also rose up. Multi-factor regression analysis indicated that venerable age, high level education, alcohol drinking, history of stroke or transient ischemic attack, fasting glucose, low density lipoprotein were risk factors, while physical exercise and high density lipoprotein were protective factors. The risk factor of fasting glucose was mainly in males (OR=1.31, 95%CI: 1.11-1.55), and no effect was observed for females (OR=1.00, 95%CI: 0.79-1.27). The protective factor of high density lipoprotein was mainly in females (OR=0.13, 95%CI: 0.05-0.35), and no effect was observed for males (OR=1.15, 95%CI: 0.39-3.37). Conclusion A higher abnormal detection rate of ultrasonic in carotid existed. Venerable age, high level education, alcohol drinking, history of stroke or transient ischemic attack, fasting glucose, low density lipoprotein were risk factors, while physical exercise and high density lipoprotein were protective factors.