颈动脉和下肢动脉粥样硬化的超声检查及其危险因素分析

目的:探讨颈动脉和下肢动脉粥样硬化(AS)的超声检查结果及其危险因素,阐明各危险因素对不同部位AS的作用程度。方法:选择颈动脉及下肢动脉彩色多普勒超声检查的受检者366名,根据超声影像学结果将其分为健康组(n=133)、单纯颈动脉硬化组(CAD组,n=42)、单纯下肢动脉硬化组(PAD组,n=69)和颈动脉硬化并发下肢动脉硬化组(CAD+PAD组,n=122)。分析各组受检者的性别、年龄、吸烟史、饮酒史、高血压(HBP)、糖尿病(DM)史、高血脂和体质量指数(BMI)等危险因素,并对下肢动脉硬化斑块形成危险因素进行Logistic回归分析。结果:受检者中颈动脉斑块的检出率为44.8%(164/366),下肢动脉硬化的检出率为52.1%(191/366)。与健康组比较,PAD组和CAD+PAD组受检者的年龄、吸烟率、HBP检出率及高血糖的检出率升高(P<0.05)。与CAD组比较,PAD组和CAD+PAD组受检者吸烟率及DM检出率均升高(P<0.01)。Logistic回归分析,男性、高龄(45~59、60~74、≥75岁)、吸烟和高血糖是下肢动脉硬化的危险因素(OR=2.520,OR=3.056,OR=6.895,OR=29.483,OR=4.136,OR=3.736,P<0.001)。结论:AS的形成是多重因素共同作用的结果,高龄、吸烟和高血糖是AS斑块形成的重要危险因素,其中吸烟和高血糖者下肢AS的发病率明显高于颈动脉。

Ultrasonic examination of carotid artery and peripheral artery atherosclerosis and their risk factors

Objective To investigate the ultrasonic examination results of carotid artery and peripheral artery atherosclerosis and their risk factors,and to clarify the effect degrees of different risk factors on the different parts of atherosclerosis. Methods 366 cases who accepted the color doppler ultrasound to exam the carotid artery and peripheral artery were divided into healthy group (n=133),simple carotid artery disease group(CAD,n=42),simple peripheral disease group (PAD,n=69),and peripheral disease combined with carotid artery disease group(CAD+PAD,n=122).The information of age,gender,smoking,drinking,high blood pressure(HBP),blood sugar, hyperlipemia and body mass index(BMI) of the objects in various groups were analyzed,and the risk factors of the incidence of different artery atherosclerosis plaque were analyzed by Logistic regression analysis. Results The detection rate of carotid plaque was 44.8% (164/366),which was 52.1% (191/366) for peripheral artery atherosclerosis.The age,rate of smoking,detection rate of HBP and detection rate of hyperglycaemia of the objects in PAD group and CAD+PAD group were higher than those in healthy group(P<0.05).The rate of smoking and rate of hyperlipemia of the objects in PAD group and CAD+PAD group were higher than those in CAD group(P<0.01).The male,elderly(45-59,60-74,and ≥75 years),smoking,and hyperglycaemia were the risk factors for the formation of peripheral artery atherosclerosis plaque(OR=2.520,OR=3.056,OR=6.895,OR=29.483,OR=4.136,OR=3.736,P<0.001). Conclusion The formation of artery atherosclerosis plaque is determined by multiple factors.The elderly,smoking and hyperglycaemia are risk factors for the formation of artery atherosclerosis plaque.Among the smoking or hyperglycaemia population,the incidence of peripheral artery atherosclerosis is obviously higher than the incidence of carotid artery atherosclerosis.