中青年人颈动脉粥样硬化病变的相关危险因素分析  

Risk factors for carotid atherosclerotic lesions in middle adults

作　　者：马艳波 华扬[2] 刘桂梅 孟秀峰 崔立平 Ma Yanbo;Hua Yang;Liu Guimei;Meng Xiufeng;Cui Liping(Department of Ultrasound,Tsinghua University Hospital,Beijing 100084,China;Department of Vascular Ultrasonography,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]清华大学医院超声科,北京100084 [2]首都医科大学宣武医院血管超声诊断科,北京100053

出　　处：《中华医学超声杂志（电子版）》2023年第8期822-826,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的应用颈动脉多普勒超声(CDU)分析中青年人颈动脉粥样硬化(CAS)病变,探讨CAS相关危险因素。方法纳入2020年1月至2020年12月在清华大学医院接受健康体检且行CDU检查的<60岁的中青年人共607例。收集CDU、脑血管病危险因素及实验室检查结果。以颈部动脉内-中膜增厚(IMT≥1.0 mm)作为早期动脉粥样硬化标志,将受检者分为CAS组(271例)及无CAS组(336例),并将CAS组进一步分为单纯IMT增厚组(100例)及颈动脉粥样硬化斑块(CAP)组(171例)。通过Logistic回归分析CAS及CAP形成的独立危险因素。结果纳入的中青年人中CAS总检出率为44.6%(271/607),男性检出率55.3%(187/338)高于女性的31.2%(84/269,P<0.01)。CAS组内单纯IMT增厚者占36.9%(100/271),IMT增厚并CAP者占63.1%(171/271),无颈部动脉狭窄(狭窄率≥50%)者。CAP形成者中,锁骨下动脉斑块136例(136/607,22.4%)。Logistic回归分析显示高血压病(OR=2.174,95%CI:1.35~3.49,P=0.001)、高脂血症(OR=1.957,95%CI:1.37~2.80,P<0.001)是中青年人CAS的独立危险因素。高血压病(OR=2.332,95%CI:1.24~4.37,P=0.008)及高脂血症(OR=1.659,95%CI:1.00~2.75,P=0.049)同样是中青年人CAP形成的独立危险因素。结论中青年男性的CAS发生率高于女性,高血压病、高脂血症是中青年人CAS与CAP形成的重要危险因素。Objective To analyze carotid atherosclerosis(CAS)in middle adults using carotid Doppler ultrasound(CDU),and to identify the risk factors for CAS.Methods A total of 607 healthy subjects under the age of 60 who underwent physical examination at Tsinghua University Hospital from January 2020 to December 2020 were involved.Data including CDU,cerebrovascular risk factors,and laboratory tests were collected.Carotid intima-media thickening(IMT≥1.0 mm)was used as a marker of early CAS.The subjects were divided into either a CAS group(271 cases)or a non-CAS group(336 cases),and the CAS group was further divided into an IMT thickening group(100 cases)and a carotid atherosclerotic plaque(CAP)group(171 cases).Independent risk factors for CAS and CAP were analyzed by Logistic regression.Results The total detection rate of CAS in middle adults was 44.6%(271/607),which was higher in males(55.3%,187/338)than in females(31.2%,84/269;P<0.01).In the CAS group,the detection rate of IMT alone was 36.9%(100/271),and that of IMT with CAP was 63.1%(171/271),without carotid stenosis(stenosis rate≥50%).In the CAP group,subclavian artery plaques were detected in 136 cases(136/607,22.4%).Logistic regression analysis showed that hypertension(odds ratio[OR]=2.174,95%confidence interval[CI]:1.35-3.49,P=0.001)and hyperlipidemia(OR=1.957,95%CI:1.37-2.80,P<0.001)were risk factors for CAS in middle adults.Hypertension(OR=2.332,95%CI:1.24-4.37,P=0.008)and hyperlipidemia(OR=1.659,95%CI:1.00-2.75,P=0.049)were also identified to be risk factors for CAP in middle adults.Conclusion The prevalence of CAS in males is higher than that in females,and hypertension and hyperlipidemia are important risk factors for CAS and CAP in middle adults.

关 键 词：动脉粥样硬化 颈动脉多普勒超声 内-中膜厚度 危险因素 

分 类 号：R543.4[医药卫生—心血管疾病]