颈动脉斑块形成的危险因素分析  

Analysis of risk factors for carotid artery plaque formation

作　　者：黄丽涓 陈小玮[1] 陈湘粤 刘友员 Huang Lijuan;Chen Xiaowei;Chen Xiangyue;Liu Youyuan(Department of Ultrasonic Medicine,Brain Hospital of Hunan Province(the Second People's Hospital of Hunan Province)Changsha City,Hunan Province,410007,China)

机构地区：[1]湖南省脑科医院(湖南省第二人民医院)超声医学科,长沙市410007

出　　处：《现代电生理学杂志》2024年第2期71-76,共6页Journal of Modern Electrophysiology

基　　金：湖南中医药大学校级科研项目(2022XYLH082)。

摘　　要：目的探讨颈动脉斑块形成与常见危险因素的相关性。方法选择湖南省脑科医院行颈动脉彩超检查的167例患者,并根据颈动脉彩超结果分为内中膜(IMT)正常组51例、IMT增厚组51例、颈动脉斑块组65例,记录并用One-Way ANOVA分析或Kruskal-Wallis检验比较3组患者一般资料的差异。再用多因素logistic回归与逐步回归分析影响颈动脉斑块形成的因素,最后绘制受试者工作特征(ROC)曲线比较这些影响因素对颈动脉斑块的诊断价值。结果3组患者的基本资料比较,斑块组收缩压、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(HCY)、纤维蛋白原(FIB)明显高于IMT增厚组和正常组(P<0.05);斑块组的白蛋白低于IMT增厚组和正常组(P<0.05);斑块组的高密度脂蛋白胆固醇(HDL-C)低于IMT增厚组和正常组(P<0.05)。采用多因素logistic回归与逐步回归分析,发现FIB、HCY、LDL-C、TG为颈动脉斑块的独立危险因素(P<0.05,OR>1)。ROC曲线显示,TG和LDL-C对颈动脉斑块形成预测价值最大,ROC曲线下面积分别为0.734(95%CI0.653~0.814)和0.713(95%CI0.634~0.792)。结论FIB、HCY、LDL-C、TG是影响颈动脉斑块形成的独立危险因素。LDL-C、TG对颈动脉斑块的预测价值最大。Objective To investigate the correlation between the formation of carotid plaques and common risk factors.Methods One hundred and sixty-seven patients who underwent carotid ultrasound examination in Hunan Brain Hospital were enrolled and divided into three groups according to the carotid ultrasound results:a normal intima-media thickness(IMT)group with 51 patients,a thickened IMT group with 51 patients,and a carotid plaque group with 65 patients.The general data of the patients in the three groups were recorded and compared using One-Way ANOVA analysis or Kruskal-Wallis test.Multifactorial logistic regression and stepwise regression analysis were used to identify factors influencing the formation of carotid plaques,and receiver operating characteristic(ROC)curves were drawn to compare the diagnostic value of these factors for carotid plaques.Results Compared with the basic data of the three groups,systolic blood pressure,total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),homocysteine(HCY)and fibrinogen(FIB)in carotid plaque group were significantly higher than those in thickened IMT group and normal group(P<0.05).The albumin of plaque group was lower than that of thickened IMT group and normal IMT group(P<0.05).high-density lipoprotein cholesterol in carotid plaque group was lower than that in thickened IMT group and normal IMT group(P<0.05).Multivariate logistic regression and stepwise regression analysis showed that FIB,HCY,LDL-C and TG were independent risk factors for carotid artery plaque(P<0.05,OR>1).ROC curve showed that TG and LDL-C had the greatest predictive value for carotid plaque formation,and the areas under curve were 0.734(95%CI0.653-0.814)and 0.713(95%CI 0.634-0.792),respectively.Conclusion FIB,HCY,LDL-C,and TG are independent risk factors affecting the formation of carotid plaques.LDL-C and TG have the highest predictive value for carotid plaques.

关 键 词：脑卒中 颈动脉斑块 超声检查 多普勒 危险因素 

分 类 号：R54[医药卫生—心血管疾病]