海南省黎族人群颈动脉粥样硬化斑块与血脂水平的相关性研究  

Relationship between carotid atherosclerotic plaque and blood lipid in the Li ethnic group in Hainan province

作　　者：赵月娥[1] 吴才标 李育新[3] 郑柏 桂茂崇[1] ZHAO Yuee;WU Caibiao;LI Yuxin;ZHENG Bai;GUI Maochong(Department of Ultrasonography,Chinese Medicine Hospital of Hainan Province,Haikou 570203,China;Department of Ultrasonography,The Second People's Hospital of Hainan Province,Wuzhishan 572299,China;Department of Neurology,The Second People's Hospital of Hainan Province,Wuzhishan 572299,China)

机构地区：[1]海南省中医院超声科,海口570203 [2]海南省第二人民医院超声科,海南五指山572299 [3]海南省第二人民医院神经内科,海南五指山572299

出　　处：《中国医科大学学报》2020年第1期58-61,66,共5页Journal of China Medical University

基　　金：海南省自然科学基金（818MS158）

摘　　要：目的探讨海南省黎族人群颈动脉粥样硬化斑块与血脂各项指标的相关性。方法选择2016年5月至2018年10月海南省第二人民医院神经内科经颈动脉超声发现的有颈动脉斑块的320例黎族患者,根据超声检查结果分为稳定斑块组(158例)和不稳定斑块组(162例)。采用t检验、χ^2检验比较2组年龄、性别、体质量指数(BMI)、血脂、载脂蛋白A1(ApoA1)、载脂蛋白B、同型半胱氨酸(Hcy)的差异。运用logisic回归分析颈动脉不稳定斑块发生与血脂指标的相关性以及不稳定斑块发生的影响因素。结果与不稳定斑块组比较,稳定斑块组年龄、是否吸烟、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、ApoA1、Hcy差异有统计学意义(均P<0.05);在对年龄、性别、BMI、高血压、糖尿病、吸烟等因素校正后,logistic回归结果显示,HDLC(OR=0.186,95%CI:0.110~0.136,P<0.001)、ApoA1(OR=0.177,95%CI:0.107~0.292,P<0.001)是颈动脉不稳定斑块的保护因素;LDLC(OR=2.014,95%CI:1.372~2.954,P<0.001)是危险因素。Logisitic逐步回归结果显示,年龄、HDLC、ApoA1、Hcy是黎族患者不稳定斑块发生的影响因素(P<0.05)。结论HDLC、ApoA1是黎族人群不稳定斑块发生的保护因素;而年龄、LDLC、Hcy是黎族人群不稳定斑块发生的危险因素。Objective To investigate the association between the plasma lipid parameters and the presence of unstable plaques in the Li ethnic population with carotid plaques in the Hainan province.Methods A total of 320 patients of Li ethnicity with carotid artery plaques detected by carotid ultrasound between May 2016 and October 2018 were selected and divided into the stable plaque group(n=158)and unstable plaque group(n=162),based on the ultrasound examination results.The plasma lipid and homocysteine(Hcy)levels were determined in all subjects.The differences in age,sex,body mass index(BMI),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDLC),and levels of apolipoprotein A1(ApoA1),apolipoprotein B,and Hcy between the two groups were compared using t-test and chi-square test.Logistic regression analysis was performed to analyze the correlation between the occurrence of unstable carotid plaques and lipid parameters and the factors influencing the occurrence of unstable plaque.Results In comparison with the patients in the unstable plaque group,statistically significant differences were noted in age,smoking,and levels of TG,HDLC,LDLC,ApoA1,and Hcy(P<0.05)in patients in the stable plaque group.After adjusting for age,sex,BMI,hypertension,diabetes,smoking and betel nut consumption,logistic analysis revealed that the following parameters were associated with unstable carotid plaques:HDLC(OR=0.186,95%CI:0.110-0.136,P<0.001),ApoA1(OR=0.177,95%CI:0.107-0.292,P<0.001),and LDLC(OR=2.014,95%CI:1.372-2.954,P<0.001).Among these parameters,HDLC and ApoA1 were protective factors against unstable carotid plaque,while LDLC was a risk factor.Stepwise logistic regression analysis indicated that age and HDLC,ApoA1,and Hcy levels were factors influencing unstable plaques in patients of Li ethnicity(P<0.05).Conclusion HDLC and ApoA1 are protective factors for unstable plaques in the Li ethnic population,while age,LDLC,and Hcy were risk factors for unstable plaques.

关 键 词：动脉粥样硬化 颈动脉超声 血脂 黎族 斑块 影响因素 

分 类 号：R543.4[医药卫生—心血管疾病]