脑卒中1046例颈动脉粥样硬化超声特点及危险因素分析  

Ultrasound characteristics and risk factors of carotid atherosclerosis in 1046 stroke patients

作　　者：付文学 何年安 赵志宏 丁作鹏 刘力 隋秀芳 FU Wenxue;HE Nian’an;ZHAO Zhihong;DING Zuopeng;LIU Li;SUI Xiufang(Department of Ultrasound,Provincial Hospital Affiliated to Anhui Medical University,Hefei,Anhui 230001,China)

机构地区：[1]安徽医科大学附属省立医院超声科,安徽合肥230001

出　　处：《安徽医药》2020年第8期1571-1574,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨脑卒中病人颈动脉粥样硬化的超声特点及主要危险因素,为脑卒中的防治提供科学依据。方法收集2016年1月至2018年5月安徽医科大学附属省立医院1 046例脑卒中病人的临床及颈动脉超声检查资料,采用χ~2检验分析脑卒中病人颈动脉超声检查结果的特点及不同年龄组、不同慢性病之间超声检查结果的差异,采用logistic回归分析颈动脉粥样硬化的危险因素。结果 1 046例脑卒中病人中,左侧颈动脉斑块形成发生率更高(62.72%),且更易多发(32.60%)。斑块检出率:颈总动脉(52.58%)>颈动脉窦部(44.26%)>颈内动脉(12.52%)。不同年龄组的脑卒中病人颈动脉内中膜厚度(IMT)增厚、斑块形成、中度以上狭窄的发生率间差异有统计学意义(P<0.05)。合并高血压者颈动脉IMT增厚、斑块形成、中度以上狭窄的检出率(87.73%、75.06%、9.95%)与无高血压者(77.57%、63.97%、4.78%,P<0.05)比较差异有统计学意义;合并糖尿病者颈动脉IMT增厚、斑块形成的检出率(90.14%,78.10%)与无糖尿病者(83.29%、70.08%,P<0.05)比较差异有统计学意义;合并高血脂者颈动脉IMT增厚的检出率(89.95%)与无高血脂者(83.87%,P<0.05)比较差异有统计学意义。logistic回归分析显示斑块形成的危险因素是高龄、男性、高血压、高体质量指数(BMI);中度及以上狭窄的危险因素是高龄、男性、高血压。结论超声可有效评估脑卒中病人颈动脉粥样硬化的特点及危险因素,对有效预防颈动脉粥样硬化及脑卒中有重要价值。Objective To explore the ultrasound characteristics and main risk factors of carotid atherosclerosis in stroke patients,and provide a scientific basis for the prevention and treatment of stroke.Methods The clinical data and carotid ultrasound examination data of 1 046 patients who were diagnosed as stroke were collected.The characteristics of carotid ultrasound findings in stroke patients were analyzed by χ~2 test.Differences in ultrasound findings between different age groups and different chronic diseases by χ~2 test.The risk factors of carotid atherosclerosis were analyzed by Logistic regression.Results Among 1 046 stroke patients,the incidence of left carotid plaque formation was higher(62.72%)and more common(32.60%).Plaque detection rate:common carotid artery(52.58%)> carotid sinus(44.26%)> internal carotid artery(12.52%).There were significant differences in the incidence of carotid intima thickening,plaque formation,and moderate and above stenosis in stroke patients of different age groups(P<0.05).The carotid intima thickening(87.73% vs.77.57%),plaque formation(75.06% vs.63.97%),moderate and above stenosis(9.95% vs.4.78%)in patients with hypertension were higher than those in without hypertension,the difference was statistically significant(P<0.05).The carotid intima thickening(90.14% vs.83.29%)and the detection rate of plaque formation(78.10% vs.70.08%)in patients with diabetes mellitus were higher than those in patients without diabetes,the difference was statistically significant(P<0.05).The detection rate of carotid intima thickening in patients with hyperlipidemia(89.95% vs.83.87%)was higher than that in patients without hyperlipidemia,the difference was statistically significant(P<0.05).Logistic regression analysis showed that the risk factors for plaque formation were advanced age,male,hypertension,and high body mass index;the risk factors for moderate and above stenosis were advanced age,male,and hypertension.Conclusion Ultrasound can effectively evaluate the characteristics and risk factors of c

关 键 词：卒中 颈动脉内膜中膜厚度 颈动脉超声检查 动脉硬化 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]