症状与无症状性颈动脉粥样硬化狭窄的临床特征对比  

Clinical features of symptomatic and asymptomatic atherosclerosis carotid artery stenosis: a comparative analysis

作　　者：黄元志 韦玮[1] 刘赟[1] HUANG Yuanzhi WEI Wei LIU Yun(Department of Neurosurgery, Affiliated Hospital of Yan＇an University Yan＇an University Medical School, Yan＇an 716000, China)

机构地区：[1]延安大学附属医院神经外科 [2]延安大学医学院,陕西延安716000

出　　处：《中华神经外科疾病研究杂志》2017年第4期297-300,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨症状性与无症状性粥样硬化性颈动脉狭窄患者临床特征的差异。方法将418例经脑血管造影检查诊断为颈动脉狭窄的患者,分为有症状组272例和无症状组146例,另随机选择100例脑血管造影检查无颈动脉狭窄患者作为对照组,比较各组患者临床特征。结果多因素Logistic回归分析结果显示吸烟(OR=2.435,95%CI=1.816~8.215,P=0.019)、冠心病(OR=4.831,95%CI=2.471~12.908,P=0.007)、高血压(OR=2.375,95%CI=1.178~6.629,P=0.022)、糖尿病(OR=1.723,95%CI=1.117~2.930,P=0.041)及低密度脂蛋白胆固醇(OR=1.966,95%CI=1.218~3.626,P=0.030)均是颈动脉狭窄的危险因素。有症状组与无症状组比较,两组患者在吸烟(47.8%vs 36.3%,P=0.024)、冠心病(47.1%vs 29.5%,P=0.000)、糖尿病(24.3%vs 12.3%,P=0.004)、溃疡性斑块(19.5%vs10.3%,P=0.015)及对侧颈动脉狭窄(29.8%vs 20.5%,P=0.042)5个方面差异具有统计学意义。结论与无症状性颈动脉狭窄患者比较,症状性颈动脉狭窄患者更多合并吸烟、冠心病、糖尿病,影像学检查更多表现为颈动脉溃疡性斑块和双侧颈动脉狭窄。Objective The clinical features of symptomatic and asymptomatic carotid artery stenosis were analyzed. Methods A total of 418 patients with carotid artery stenosis were divided into symptomatic group （272 cases） and asymptomatic group （146 cases）. One hundred patients without carotid artery stenosis in our hospital were randomly selected as the control group. All patients were examined by cerebral angiography. The clinical feattaes were compared among different groups. Results Mtdtivariable Logistic regression analysis showed that smoke （OR =2.435, 95% CI =1.816 -8.215, P=0.019）, coronary heart disease （OR =4.831, 95% CI =2.471 -12.908, P=0.007）, hypertension （OR =2.375, 95% CI =1. 178-6.629, P=0.022）, diabetes （OR =1.723, 95% CI = 1.117 -2. 930, P =0. 041 ） and low density lipoprotein cholesterin （ OR = 1.966, 95% CI = 1.218 ~ 3. 626, P =0. （B0） were associated with carotid artery stenosis. There was significant difference in smoke （47. 8% vs 36. 3%, P =0.024）, coronary heart disease （47. 1% vs 29.5%, P =0. 000）, diabetes （24. 3% vs 12. 3%, P = 0. 004）, ulcerated plaques （ 19. 5% vs 10. 3%, P =0. 015） and contralateral carotid artery stenosis （29.8% vs 20.5%, P = 0.042） between symptomatic group and asymptomatic group. Conclusion Compared to asymptomatic group, more patients in symptomatic group are found with smoking history, coronary heart disease, diabetes, ulcerated plaques and contralateral carotid artery stenosis.

关 键 词：症状性颈动脉狭窄 无症状性颈动脉狭窄 数字减影脑血管造影术 

分 类 号：R743[医药卫生—神经病学与精神病学]