高原脑卒中高危汉族人群颈动脉斑块与相关检验指标的研究  

Carotid artery plaques and related laboratory test parameters in high-risk stroke Han population at high altitude

作　　者：铁婷婷 王兰桂[1] 黄茜[1] 旦祥 杨占银[2] 马丽萍[1] 张璟 焦猛 Tie Tingting;Wang Langui;Huang Qian;Dan Xiang;Yang Zhanyin;Ma Liping;Zhang Jing;Jiao Meng(Department of Neurology,Affiliated Hospital of Qinghai University,Xining810001,Qinghai Province,China)

机构地区：[1]青海大学附属医院神经内科,西宁810001 [2]青海省海南藏族自治州人民医院神经内科,西宁810001 [3]青海大学研究生院,西宁810001

出　　处：《中华老年心脑血管病杂志》2020年第10期1062-1065,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：青海大学附属医院中青年科研基金重点项目(ASRF-2016-ZD-03)。

摘　　要：目的分析不同海拔地区脑卒中高危汉族人群颈动脉斑块与血浆同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)和血红细胞计数(RBC)的关系。方法采用随机整群抽样方法,筛查常住青海西宁地区(海拔约2200 m,中海拔)和青海海南州地区(海拔约3000m,高海拔)年龄≥60岁的脑卒中高危人群300例,根据海拔分为中海拔组150例和高海拔组150例,用颈动脉彩色超声测量颈总动脉内膜中层厚度(IMT),用循环酶法测定血浆Hcy水平,散射比浊法测定血浆hs-CRP水平,用血细胞分析仪分析RBC。进行Pearson相关性分析和多因素logistic回归分析。结果高海拔组颈动脉斑块检出率明显高于中海拔组(53.3%vs 41.3%,χ2=4.332,P=0.037);2组斑块者血浆Hcy、hs-CRP、LDL-C和IMT高于无颈斑块者(P<0.01)。多因素logistic回归分析显示,IMT、血浆Hcy、hs-CRP、RBC是颈动脉斑块形成的危险因素(P<0.05,P<0.01);高海拔组血浆Hcy、hs-CRP和RBC高于中海拔组(P<0.01)。结论血浆Hcy、hs-CRP和RBC是高海拔环境颈动脉斑块发生的危险因素。Objective To analyze the relationship of carotid artery plaques with plasma Hcy and hs-CRP levels and RBC count in high-risk stroke Han population at different high altitudes.Methods Three hundred high-risk stroke Han people aged≥60years randomly selected from Qinghai Xining area at an altitude of about 2200mand Qinghai Hainan Tibetan Autonomous Prefecture area at an altitude of about 3000mwere divided into medium altitude group(n=150)and high altitude group(n=150).Their carotid IMT was measured by color ultrasonography,their plasma Hcy level was measured by enzymatic cycling assay,their plasma hs-CRP level was measured by scattering nephelometry,and their RBC count was analyzed with a blood cell analyzer.The relationship of carotid artery plaques with plasma Hcy and hs-CRP levels and RBC count was analyzed by Pearson correlation analysis and multivariate logistic regression analysis respectively.Results The detection rate of carotid artery plaques was significantly higher in high altitude group than in medium altitude group(53.3%vs 41.3%,χ2=4.332,P=0.037).The plasma Hcy,hs-CRP,LDL-C levels were significantly higher and the carotid IMT was significantly thicker in people with carotid artery plaques than in those without carotid artery plaques(P<0.01).Pearson correlation analysis and multivariate logistic regression analysis showed that IMT,plasma Hcy and hs-CRP levels and RBC count were the independent risk factors for carotid artery plaques(P<0.05,P<0.01),the plasma Hcy and hs-CRP levels were significantly higher and the RBC count was significantly greater in high altitude group than in medium altitude group(t=4.298,P<0.01,t=5.772,P<0.01,t=4.498,P<0.01).Conclusion Plasma Hcy and hs-CRP levels and RBC count are the risk factors for carotid artery plaques at high altitude.

关 键 词：高海拔 卒中 颈动脉疾病 高半胱氨酸 C反应蛋白质 红细胞计数 脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]