早期与进展期动脉粥样硬化危险因素的比较研究

目的 比较早期动脉粥样硬化和进展期动脉粥样硬化的危险因素.方法 使用磁共振血管造影术以及高分辨率B超扫描术,纳入进展期动脉粥样硬化（动脉粥样硬化性脑梗死/短暂性脑缺血发作）的患者92例;早期动脉粥样硬化（无心脑血管疾病而且颈动脉B超检查颈动脉狭窄率〈40%）的患者120例,分别应用二元Logistic回归分析,比较早期以及进展期动脉粥样硬化的危险因素的异同（P〈0.15为差异有统计学意义）.结果 颈动脉斑块形成的二元Logistic模型里,传统的危险因素,年龄（OR值：1.101,95%CI：1.046～1.159,P〈0.001）、高TC（OR值：2.236,95%CI：0.821～6.089,P=0.115）、高血压（OR值：2.623,95%CI：0.989～6.957,P=0.053）、吸烟,（OR值：7.975,95%CI：2.274～27.9651,P=0.001）是具有统计学意义的自变量.进展期动脉粥样硬化的二元Logistic模型,男性（OR值：2.064,95%CI：1.137～3.748,P=0.017）、高脂蛋白（a）（OR值：2.818.95%CI：1.499～5.298,P=0.001）、低HDL-C（OR值：2.451,95%CI：1.234～4.868,P=0.010）、糖尿病（DR值：2.414,95%CI：1.232～4.731,P=0.010）是具有统计学意义的自变量.结论 进展期动脉粥样硬化的危险因素与早期动脉粥样硬化的危险因素有所不同,糖尿病、脂蛋白（a）在进展期动脉粥样硬化中有重要作用.

Comparative study of risk factors for early and advanced atherosclerosis

Objective The purpose of this study is to compare the risk factors for the two different atherosclerosis processes, namely the early atherosclerosis and advanced atherosclerosis. Methods Using magnetic resonance angiography and high-resolution B-mode ultrasonography, 92 patients with advanced atherosclerosis （atherosclerotic cerebral infarction/transient ischemic attack） and 120 patients with early atherosclerosis （no cardiovascular and cerebrovascular diseases and carotid stenosis 〈 40% on B-mode ultrasonography） were included. The difference and similarity of the risk factors for early atherosclerosis and advanced atherosclerosis were compared respectively using the binary logistic regression. Results In the binary logistic model of carotid plaque formation, the traditional risk factors, such as age （years） （ OR, 1.101, 95%CI：1.046- 1.159, P 〈0.001）, high TC （OR, 2. 236,95%CI：0.821 -6.089, P = 0. 0115）, hypertension （ OR, 2. 623,95% CI： 0. 989 - 6. 957, P = 0. 053 ）, and smoking （%） （ OR, 7. 975,95% CI：2. 274 - 27. 9651, P =0. 001 ） were the statistically significant independent variables. In the binary logistic model of advanced atherosclerosis, male （ OR, 2. 064,95% CI： 1. 137 - 3. 748, P = 0.017）, high Lp （a） （OR, 2. 818,95%CI：1.499 -5. 298, P =0.001）, low HDL （OR,2.451,95%C/： 1. 234 - 4. 868, P = 0. 010）, and diabetes mellitus （ OR, 2. 414,95% CI： 1. 232 - 4. 731, P = 0. 010） were the statistically significant independent variables. Conclusion The risk factors for advanced athero-sclerosis and early atherosclerosis are different, diabetes mellitus and lipoprotein （a） may play an important role in the advanced atherosclerosis.