血脂代谢与颈动脉粥样硬化不稳定性斑块的相关性  

Association Between Plasma Lipids and Unstable Carotid Plaques

作　　者：张晶[1] 关欣[2] 王伟[1] 陈孟英[1] 梁蓉[1] 

机构地区：[1]天津市胸科医院心血管内科,天津市300051 [2]天津市胸科医院超声科,天津市300051

出　　处：《中国动脉硬化杂志》2012年第9期833-836,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的在检查出颈动脉斑块的中老年人群上探讨血脂各项指标与颈动脉粥样硬化不稳定性斑块的相关性。方法选择颈动脉超声检查检出斑块的患者270例,根据超声检查结果分为不稳定性斑块组130例和稳定性斑块组140例。对所有对象检验血脂各项指标。结果在对年龄、性别、高血压、糖尿病、吸烟等因素进行校正后,Logistic回归结果显示,非高密度脂蛋白胆固醇Non-HDLC(OR=1.27,95%CI 1.02～1.58,P=0.032)、TC/LD-LC(OR=1.67,95%CI 1.17～2.38,P=0.005)、apoB(OR=4.53,95%CI 1.21～16.94,P=0.025)、apoB/apoA1(OR=17.85,95%CI 3.63～87.87,P<0.001)等指标是颈动脉不稳定性斑块发生的危险因素,apoA1(OR=0.18,95%CI 0.04～0.87,P=0.032)是颈动脉不稳定性斑块生成的保护因素。危险因素分析发现指标apoB/apoA1是颈动脉不稳定性斑块生成的独立危险因素。结论 apoB/apoA1可能是中老年人发生颈动脉不稳定性斑块的独立预测指标。Aim To investigate the association between plasma lipids and presence of unstable carotid plaques in middle-aged and elderly people with carotid plaques. Methods Two hundred and seventy patients with carotid plaques detected by B-mode ultrasonography were enrolled in the study and divided into the unstable plaque group （n = 130） and the control group（n = 140）. The plasma lipid levels were also determined in all subjects. Results After the adjustment of age, gender, hypertension, diabetes and smoking, the Logistic analysis revealed that the following lipid parameters are associated with unstable carotid plaque ： Non-HDLC（ OR = 1.27,95% CI 1.02 - 1.58, P = 0. 032 ）, TC/ LDLC （OR = 1.67,95% CI 1.17 - 2. 38, P = 0. 005）, apoB （ OR = 4. 53, 95% CI 1.21 - 16. 94, P = 0. 025） and apoB/ apoA1 （ OR = 17.85,95% CI 3.63 - 87. 87, P 〈 0. 001 ） . Among them, apoA1 was the protective factor of unstable ca- rotid plaque, while the others were risk factors. In addition, apoB/apoA1 was determined as the independent risk factor of the presence of unstable carotid plaque. Conclusions These results suggest that apoB/apoA1 can be used as an in- dependent predictive index to assess the risk of unstable carotid plaque formation in middle-aged and elderly people.

关 键 词：血脂 颈动脉粥样硬化 颈动脉斑块 危险因素 

分 类 号：R5[医药卫生—内科学]