头颈部恶性肿瘤颈动脉狭窄的多因素回归分析

 目的探讨头颈部恶性肿瘤放疗后颈动脉狭窄的危险性因素.方法28例病理证实头颈部恶性肿瘤患者作为检查组,并选取27例未放疗肿瘤患者作对照组.所有患者的双侧颈总、颈内和颈外动脉均行彩色多普勒超声检查.对年龄、性别、吸烟、高血压、冠心病、脑血管病、糖尿病、高血脂、颈部手术及颈部放疗,进行数量化定义,并输入计算机,先用单因素Logistic回归分析,并在此基础上选择有意义的因素进行多因素Logistic回归分析.数据应用SPSS7.5软件包进行统计分析.结果头颈部肿瘤颈部放疗后患颈动脉狭窄率55.4%,明显高于普通人群患颈动脉粥样硬化率36.9%.对照组患者罹患率为36.3%.多因素Logistic回归分析显示放疗后颈动脉狭窄与年龄、放疗、冠心病、高血压均有明显关系.结论放射治疗对于头颈部恶性肿瘤是行之有效的治疗方法,但也是除明确的常见危险因素外,颈动脉狭窄的促成因素之一.

Irradiation- induced extracranial carotid stenosis in patients with head and neck mannancies: a multivariate logistic regression analysis

Objective To investigate the prevalence of radiation-induced carotidartery disease and to identify risk factors associated with significant carotid stenosis.Methods In a comparative cross-sectional study,carotid arteries color flow Doppler scan was performed in 28 patients who had received external irradiation to the head and neck area,with a mean peiod of 22 months after radiotherapy.A group of 27 patients without irradiation were used as controls.Results Carotid stenosis rates in irradiation group and the control group were 55.4% and(36.3%),respectively.It was associated with age,smoking,coronary heart disease,hypertension,diabetes mellitus,hyperlipidemia,and irradiation.On logistic regression analysis,age(>60 years),irradiation,hypertension,and coronary heart disease were found to be independent significant(P<0.05) predictors.Conclusions Patients who received radiotherapy to the head and neck have a high risk of developing significant carotid stenosis.Routine Doppler ultrasound scanning in these patients is indicated.