颈动脉易损斑块磁共振特征与临床危险因素评分的相关性分析  

Correlation analysis between MRI characteristics of carotid vulnerable plaques and clinical risk factors score

作　　者：杨梅[1] 周丹[1] YANG Mei;ZHOU Dan(Department of Radiology,BenQ Medical Center,Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院放射科,江苏南京210019

出　　处：《实用放射学杂志》2020年第11期1759-1762,共4页Journal of Practical Radiology

摘　　要：目的探讨颈动脉粥样硬化易损斑块与临床危险因素积分的相关性.方法选择经超声、CTA或DSA证实至少一侧颈动脉在其分叉上下2 cm范围内有斑块的232例患者作为研究对象,均进行颈动脉高分辨率磁共振成像(HRMRI)检查.根据MRI结果将患者分为2组:易损斑块组(66例)和稳定斑块组(166例).记录患者性别、年龄、吸烟、BMI、糖尿病、血脂水平和高血压等临床信息.计算患者危险因素(性别、年龄、超重、高血压、高血脂、吸烟、糖尿病)的加权积分.统计分析危险因素积分与颈动脉斑块易损特征的相关性.结果(1)随着危险因素积分的增加,斑块出血、斑块坏死脂质核及易损斑块的发生率也增加.(2)二元Logistic回归分析显示,危险因素积分与颈动脉易损斑块正相关(OR:1.35,95%CI:1.03~1.77,P=0.03).(3)在多元Logistic回归分析中,校正性别和年龄后,发现危险因素积分与颈动脉易损斑块的相关性更高(OR:1.36,95%CI:1.2~1.82,P=0.04).(4)单因素方差分析显示,危险因素积分与颈动脉的血管外周横轴面积有相关性,差异有统计学意义(P<0.05).结论临床危险因素积分可以预测颈动脉粥样硬化斑块发生易损的风险,每增加一个危险因素,颈动脉斑块发生易损的风险增加1.36倍.Objective To investigate the relationship between carotid atherosclerotic vulnerable plaque and clinical risk factors score.Methods A total of 232 patients with plaque on at least one side of the carotid artery within 2 cm above and below the bifurcation confirmed by ultrasound,CTA or DSA were selected as the research subjects,whom were performed with carotid artery high resolution magnetic resonance imaging!HRMRI).According to the results of MRI,the patients were divided into 2 groups,vulnerable plaque group(n=166)and stable plaque group(n=166).The clinical data of sex,age,current smoking history,BMI index,diabetes hypertension,and blood lipid level were recorded.Weighted scores of controllable clinical risk factors(hypertension,diabetes,hyperlipidemia,overweight,smoking)were calculated.The correlation between risk factor scores and vulnerability of carotid plaque was statistically analyzed.Results(1)With the increase of risk factor scores,the incidence of intra-plaque hemorrhage,lipid necrosis core area and vulnerable plaque increased.(2)Two linear regression analysis showed that risk factors score was markedly correlated with carotid vulnerable plaque(OR 1.35,95%CI 1.03-1.77,P=0.03).(3)In multi-factors Logistic regression analysis,we adjusted for gender and age,and found that risk factors score was more correlated with carotid vulnerable plaque(OR 1.36,95%CI 1.2-1.82,P=0.04).(4)Univariate analysis of variance showed that the risk factors score was correlated with the area of carotid artery(P<10.05).Conclusion The score of clinical risk factors can predict the risk of vulnerable carotid atherosclerotic plaques.The risk of carotid plaque vulnerability increases by 1.36 times for every additional risk factor.

关 键 词：颈动脉 易损斑块 磁共振成像 危险因素积分 

分 类 号：R543.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]