腹围与女性脑卒中高危人群颈动脉粥样硬化相关性分析

目的:探讨腹围与女性脑卒中高危人群颈动脉粥样硬化的相关性。方法:选取2012年5月至2013年2月在北京市丰台区王佐卫生服务中心、蒲黄榆社区卫生服务中心筛查的女性脑卒中高危人群1 228例,根据腹围是否大于等于80cm,将患者分为腹围正常组和腹围增大组进行颈动脉超声检查,观察2组患者颈动脉内膜中层厚度及斑块形成情况。结果:单因素分析示:与腹围正常组相比,腹围增大组颈动脉内膜增厚及斑块形成的发生率明显增高(P0.01),颈动脉内膜增厚及斑块形成的发生率与腹围的增大呈正相关(Spearman相关系数分别为0.140、0.169)。多因素Logistic回归分析示:糖尿病病史、腹围增大、吸烟是导致颈动脉粥样硬化发生的危险因素,与颈动脉粥样硬化的发生相关。中医症状及证型分析:与腹围正常组相比,形体肥胖、口唇紫暗、头重如裹、口干等多个症状具有统计学意义(P0.01或P0.05);痰湿、血瘀两个证型在腹围增大组比例较大(P0.05)。结论:在女性脑卒中高危人群中,腹围的增大。与颈动脉内膜增厚及斑块形成呈正相关,这部分人群更应该行颈动脉超声检查。与其他危险因素相比,腹围增大合并糖尿病史的女性出现颈动脉粥样硬化的可能性更大。腹围增大的人群更以易表现出痰湿、血瘀证型。

Observation on the Correlation of Abdominal Girths and Carotid Atherosclerosis of High Risk Female Patients of Stroke

To discuss the relation between abdominal girths and carotid atherosclerosis among female patients that have high risk of stroke. Methods:A total of 1 228 women who have high risk of stroke that enrolled at Wangzuo and Puhuangyu community health service centers from May 2012 to February 2013 was selected. Then they were randomly divided into two groups according to their abdominal girths. The patients whose abdominal girths under 80 cm are the normal group, and the patients whose abdominal girths above 80 cm are the increasing group. To observe the thickness of carotid artery walls and the plaques of patients in both groups by conducting carotid artery ultrasonography. Results:Single factor analysis: comparing with the normal group, the increasing group has higher incidence of plaques and thicker carotid artery walls(P<0.01). The incidence of plaque and carotid intimal thickening is positively correlated with the increasing of abdominal girth(Spearman correlation coefficient are 0.140 and 0.169 respectively). Multi factor analysis: diabetes, increased abdominal girths, and smoking are related to the occurrence of carotid atherosclerosis. TCM symptom analysis: obesity, dark lips, head heaviness, and dry mouths are the symptoms that could induce carotid atherosclerosis(P<0.01 or P<0.05). Besides, the symptoms of phlegm damp and blood stasis present higher proportions in the increasing group(P<0.05). Conclusion:The increase of abdominal girth is positively related to the plaque and the thickness of carotid artery wall among women who have high risks of stroke. Therefore, they should conduct carotid artery ultrasonography. Comparing to other risk factors, diabetes and increasing abdominal girths are more likely to induce carotid atherosclerosis. Meanwhile, patients who have increased abdominal girths are more likely to develop phlegm dampness and blood stasis symptoms.