超声评价颈动脉内中膜厚度、狭窄及斑块影响因素的比较分析  

Comparison and analysis on the influence factors of carotid artery intima-media thickness,stenosis and plaque assessed by ultrasound

作　　者：廖焕权[1] 洪华[1] 王鸿轩[2] 陈红兵[1] 贺涓涓[3] 尚文锦[1] 周晓明[1] 

机构地区：[1]中山大学附属第一医院神经内科,广东广州510080 [2]中山大学附属第二医院神经内科,广东广州510120 [3]中山大学附属第三医院神经内科,广东广州510630

出　　处：《中风与神经疾病杂志》2014年第4期303-306,共4页Journal of Apoplexy and Nervous Diseases

基　　金：国家自然科学基金资助项目(30971028);广东省自然科学基金资助项目(06021232);广东省科技计划项目(2007B031502003);广州市科技计划项目(2009Z1-E021);中山大学附属第一医院优秀青年人才支持计划项目(18700112)

摘　　要：目的探讨超声评价颈动脉内中膜厚度(intima-media thickness,IMT)、狭窄及斑块影响因素的差异。方法对942例广州社区居民进行双侧颈动脉超声检查。结果多因素回归分析校正混杂因素的影响后,年龄、男性、吸烟、高血压病史、卒中病史、腰臀比、收缩压、低密度脂蛋白是IMTmean的独立危险因素(P<0.05),解释了其60.7%的变化。年龄、吸烟、腰臀比、高密度脂蛋白(降低)、低密度脂蛋白是颈动脉狭窄的独立危险因素(P<0.05),解释了其32.6%的变化。年龄、吸烟、收缩压、高密度脂蛋白(降低)、低密度脂蛋白是最大斑块厚度的独立危险因素(P<0.05),解释了其30.5%的变化。年龄、吸烟、低密度脂蛋白是易损斑块的独立危险因素(P<0.05),解释了其15.8%的变化。结论超声评价的颈动脉粥样硬化各指标与传统危险因素的关系并不完全一致。IMTmean与其的关系最大,其次是颈动脉狭窄和最大斑块厚度,易损斑块的关系较小。狭窄与易损斑块的形成可能更多地与炎症等非传统因素关系更为密切。Objective To investigate the differences between the influence factors of carotid artery such as intima media thickness,stenosis and plaque assessed by ultrasound. Methods Bilateral carotid artery ultrasonography was per formed on 942 community residents in Guangzhou. Results After adjustment for confounding factors using multiple factors regression analysis, age, male, smoking, high blood pressure, stroke, waisttohip ratio, systolic blood pressure, low density lipoprotein were independent risk factors for IMTmean（ P 〈 0.05 ）, explaining 60.7% changes. Age, smoking, waisttohip ratio,high density lipoprotein （lowering） , low density lipoprotein were independent risk factors for carotid stenosis （ P 〈 0.05 ） , explaining 32.6% changes. Age, smoking, systolic blood pressure, high density lipoprotein （ lowering）, low density lipoprotein were independent risk factors for maximum plaque thickness （ P 〈 0.05 ） , explaining 30.5 % changes. Age, smok ing,low density lipoprotein were independent risk factors for vulnerable plaque （P 〈 0. 05 ） , explaining 15.8% changes. Conclusions The relationships between the carotid atheroselerosis indexes assessed by ultrasound and traditional methods are not consistent. The closest relation is IMTmean and traditional risk factors, followed by carotid artery stenosis and the maximum thickness of plaque,the loosest is the vulnerable plaque. Nontraditional factors such as inflammation may have a closer impact on the formation of stenosis and vulnerable plaque.

关 键 词：超声 颈动脉 内中膜厚度 狭窄 斑块 

分 类 号：R743.3[医药卫生—神经病学与精神病学]