鼻咽癌放疗后迟发性放射性脑损伤患者颈动脉斑块形成的相关因素分析  

Study Factors Causing the Formation of Carotid Artery Plaque in Patients with Radiation-induced Late Brain Injury After Nasopharyngeal Carcinoma Radiotherapy

作　　者：陈惠[1] 卡力比努尔.吾买尔 邹烈寰 

机构地区：[1]新疆维吾尔自治区人民医院放疗科,830001 [2]新疆维吾尔自治区人民医院神经内科,830001 [3]乌鲁木齐市中医医院内科,830000

出　　处：《实用癌症杂志》2013年第4期441-443,共3页The Practical Journal of Cancer

摘　　要：目的探讨引发鼻咽癌放疗后迟发性放射性脑损伤患者颈动脉斑块形成的相关因素。方法选取2010年1月-2012年12月我院收治的120例鼻咽癌放疗后迟发性放射性脑损伤(RILBI)患者为观察组,同时以同期体检中心健康查体的120例体检者作为对照组,对比观察2组颈动脉斑块的发生率。然后根据观察组患者颈动脉有无斑块分为2组,行颈动脉的内膜-中层厚度(IMT)多重回归,筛选颈动脉斑块形成的因素,然后采用非条件Logistic回归分析斑块形成的危险因素。结果斑块检出率观察组为63.3%,对照组为10.8%,2组差异有统计学意义(P<0.05);年龄、是否高血压病、TC分组及LDL分级是鼻咽癌放疗后迟发性放射性脑损伤患者颈动脉斑块形成的相关因素,而性别、血糖、是否患有糖尿病不是相关因素;经非条件Logistic回归分析显示年龄、SBP及LDL是RILBI患者颈动脉斑块形成的危险因素(OR=1.121,95%CI:1.001-1.255,P=0.048;OR=1.087,95%CI:1.004-1.177,P=0.039;OR=1.036,95%CI:1.017-1.055,P=0.000)。结论鼻咽癌放疗后RILBI患者颈动脉斑块形成的几率较大,年龄与SBP是颈动脉斑块形成的重要危险因素,LDL是相对次要危险因素,要定期随访,以期及时发现迟发性放射性颈动脉损伤。Objective To explore the related factors causing the formation of carotid artery plaque in patients with radia- tion-induced late brain injury after nasopharyngeal carcinoma radiotherapy. Methods 120 cases of radiation-induced late brain injury （RILBI） patients after nasopharyngeal carcinoma radiotherapy were selected as the observation group, and 120 cases of healthy patients as control group, the incidence of carotid artery plaque in 2 groups were observed and compared, and then the pa- tients in the observation group were divided into 2 groups, with and without carotid plaque, intima of carotid artery -media thick- ness （IMT） multiple regression,factors causing carotid plaque were screened, risk factors of the plaque were analyzed by using non-conditional Logistic regression analysis. Results The plaque detection rate in the observation group was 63.3 % , while that in the control group was 10.8% , there was significant difference between 2 groups （P 〈 0.05 ） ;age, hypertension, TC grouping and LDL classification were the related factors for the formation of carotid artery plaque to patients with delayed radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy, while gender, blood glucose, diabetes were not the related factors ; non conditional Logistic regression analysis showed that age, SBP and LDL were the risk factors for the formation of carotid artery plaque in RILBI patients（OR = I. 121,95% CI：I. 001-1. 255 ,P =0. 048 ;OR = 1. 087,95% CI： 1. 004-1. 177,P =0. 039 ; OR = 1. 036,95% CI：I. 017-1. 055 ,P = 0.000）. Conclusion The formation of carotid artery plaque in RILBI patients after nasopha- ryngeal carcinoma radiotherapy is closely related to main risk factors ： age and SBP, and LDL is relatively minor risk factors. We should conduct follow-up regularly to discover the late radiation-induced carotid artery injury.

关 键 词：鼻咽肿瘤 脑放射性治疗 迟发性放射性脑损伤 颈动脉斑块 危险因素 

分 类 号：R739.62[医药卫生—肿瘤]