影响颈动脉斑块形成因素的临床分析

目的 分析影响颈动脉粥样斑块形成的常见临床危险因素. 方法 选择自2005年6月至2006年12月在我院行颈动脉彩超检查的住院患者279例,首先对颈总动脉的内膜-中层厚度(IMT)行多重回归分析,筛选影响颈动脉粥样硬化的因素;再将资料分为颈动脉有无斑块两组行二项分类Logistic回归及单因素分析,进一步筛选影响颈动脉斑块形成的因素;最后比较危险因素亚组间斑块积分和指数的大小. 结果 颈总动脉的IMT受年龄(age)、收缩压(SBP)及低密度脂蛋白(LDL)影响(Betaage=0.242,Page=000;BetaSBP=0.152,PSBP=0.013;BetaLDL=0.115,PLDL=0.048),但颈动脉有无斑块形成主要受年龄及SBP影响(Orage=1.087,Paeg=0.000;ORSBP=1.036,PSBP=0.000).颈动脉斑块的检出率:60岁以上组高于60岁以下组(X2=58.379,P=0.000),高血压病组高于非高血压病组(X2=18.206,P=0.000);颈动脉斑块的积分及指数的比较:60岁以上组高于60岁以下组(F=69.353,P=0.000;F=64.826,P=0.000),高血压病组高于非高血压病组(F=4.866,P=0.028;F=6.927,P=0.009).结论 年龄及SBP是颈动脉粥样斑块形成的主要危险因素,LDL是相对次要危险因素.

Clinical analysis of the risk factors of carotid atherosclerotic plaque formation

Objective To analyze the risk factors for the formation of carotid atherosclerotic plaque. Methods The clinical data of 279 hospitalized patients undergoing carotid artery color Doppler ultrasonography between June 2005 and December 2006 were collected. Multiple regression of the common carotid intimal-medial thickness (IMT) was used to screen the potential risk factors of carotid plaque formation. The patients were divided into two groups according to the presence of carotid plaque, and binary logistic regression and univariate analysis were used to identify the risk factors. The carotid plaque score and index were compared between the subgroups with different risk factors. Results The common carotid IMT was subjected to influences by age (β=0.242, P=0.000), systolic blood pressure (SBP) (β=0.152, P=0.013) and the level of low-density lipoprotein (LDL) (β=0.115, P=0.048). Age (OR=1.087, P=0.000) and SBP (OR=1.036, P=0.000) were identified as the main factors that affected the formation of carotid plaque. In patients above 60 years old, the detection rate of carotid plaque was significantly higher than that in patients below 60 years (X2=58.379, P=0.000), and the rate was significantly higher in hypertensive patients than in the normotensive patients (X2=18.206, P=0.000). The carotid plaque score and index were significantly higher in patients over 60 years old than in those below 60 years (F=69.353, P=0.000;F=64.826, P=0.000, respectively), and also significantly higher in hypertensive patients than in the normohypertensive patients (F=4.866, P=0.028;F=6.927, P=0.009, respectively). Conclusion Age and SBP are the major risk factors of carotid atheroselerotie plaque formation, and LDL is a factor of lesser risk.