中国缺血性脑卒中住院患者颈动脉粥样硬化病变性别差异的分析  

Sex differences in the prevalence of carotid atherosclerosis among hospitalized patients with acute ischemic stroke in China

作　　者：孙佳艺[1] 赵冬[1] 刘静[1] 王薇[1] 唐美莲[1] 刘军[1] 齐玥[1] 秦兰萍[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所流行病研究室,100029

出　　处：《心肺血管病杂志》2016年第2期81-86,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金："十二五"国家科技支撑计划(2011BAI08B01);2011国家医改专项:脑卒中筛查与防治工程项目

摘　　要：目的:描述我国急性缺血性脑卒中住院患者颈动脉粥样硬化的分布特征,探讨传统危险因素与颈动脉粥样硬化的关系。方法:研究病例来自全国25个省市41家三级甲等医院,连续收集2011年1月至2011年5月,住院的脑梗死患者,对资料完整且年龄≥18岁的12 424例脑卒中患者进行分析。结果:住院缺血性脑卒中患者的颈动脉斑块患病率为76.9%,颈动脉内膜(IMT)增厚率为54.3%,狭窄率≥70%的患者占7.0%,男性的颈动脉粥样硬化患病率高于女性(P<0.001),男女两性的颈动脉粥样硬化患病率随年龄的增加呈线性增加(男性:β=8.550,P=0.012;女性:β=11.100,P=0.002),但男女两性间的差异随年龄的增加逐渐减少。多因素Logistic回归分析显示,年龄、高血压和糖尿病,是男女两性脑卒中患者颈动脉粥样硬化患病的共同危险因素,高LDL与男性颈动脉斑块患病率有关,心房颤动病史与男性颈动脉IMT增厚率密切相关,吸烟仅与男性颈动脉斑块和颈动脉IMT增厚率有关。结论:我国缺血性脑卒中住院患者中颈动脉粥样硬化病变普遍存在,男性脑卒中患者的颈动脉粥样硬化患病率高于女性,传统危险因素与颈动脉粥样硬化指标间的关系存在性别差异。Objective： To describe the prevalence rate of carotid atherosclerosis in the hospitalized patients with acute ischemic stroke and to further explore the association between traditional cardiovascular risk factors and the prevalence of carotid atherosclerosis. Methods： This study is a multi-center cross-sectional study,we continuously collected information of hospitalized patients with acute ischemic stroke from 41 hospitals located in 25 provinces of China during January to May in 2011. Totally,12424 patients aged ≥18 years,with complete data were eligible for final analysis. Results： The prevalence rate was 76. 9%,54. 3% and 7. 0% for carotid plaque,carotid intima-media thickness（ IMT） ≥1. 0mm and carotid stenosis ≥70%,respectively. Men had a higher prevalence rate of carotid atherosclerosis disease than women（ P〈0. 001）,although there was a significant linear trend for the prevalence rate with aging in both men and women,the differences between men and women reduced gradually with aging. Specifically,after adjusting for other cardiovascular risk factors,age、hypertension and diabetes were associated with increased risk of carotid atherosclerosis in both men and women.Low-density lipoprotein cholesterol（ LDL-C） was associated with carotid plaque in men,atrial fibrillation were associated with increased risk of having carotid IMT in men. Smoking was associated with carotid atherosclerosis only in men. Conclusion： In the present study,carotid atherosclerosis disease was prevalent in the hospitalized patients with acute ischemic stroke,and men had a higher prevalence rate than women. There may be sex differences in the relationship between traditional cardiovascular risk factors and the prevalence of carotid atherosclerosis disease.

关 键 词：缺血性脑卒中 颈动脉粥样硬化 性别 危险因素 

分 类 号：R54[医药卫生—心血管疾病]