脑卒中高危人群颈动脉斑块形成的影响因素分析  

Influencing factors for carotid plaque among high-risk populations for stroke

作　　者：沈芳芳 吕家顺 胡伟[1] 杭燕雯 SHEN Fangfang;LU Jiashun;HU Wei;HANG Yanwen(Department of Cardiology,Minhang Hospital Affiliated to Fudan University,Shanghai 201199,China)

机构地区：[1]复旦大学附属闵行医院(上海市闵行区中心医院)心内科,上海201199

出　　处：《预防医学》2024年第12期1078-1081,共4页China Preventive Medicine Journal

基　　金：闵行区公共卫生重点学科建设项目(MGWXK2023-12);上海市加强公共卫生体系建设三年行动计划(2015年-2017年)建设项目(GWIV22)。

摘　　要：目的 探讨脑卒中高危人群颈动脉斑块形成的影响因素,为脑卒中高危人群颈动脉粥样硬化早期干预提供参考。方法 于2021年4-9月,采用多阶段整群随机抽样法抽取上海市闵行区常住居民,采用《心脑血管病危险因素社区、乡镇人群筛查量表》收集基本信息、脑卒中家族史和既往病史等资料,依据《脑卒中筛查与防治技术规范》判定脑卒中高危人群;采用颈动脉超声检查颈动脉斑块情况;采用多因素logistic回归模型分析颈动脉斑块形成的影响因素。结果调查25 666人,筛查出脑卒中高危人群8 459人,其中男性3 362人,女性5 097人,男女比为0.66︰1;年龄M (QR)为66.00(11.00)岁。脑卒中高危人群检出颈动脉斑块4 305例,检出率为50.89%。多因素logistic回归分析结果显示,年龄增长(OR=1.052,95%CI:1.043~1.061)、有脑卒中家族史(OR=1.297,95%CI:1.103~1.526)、高血压(OR=1.245,95%CI:1.025~1.512)、糖尿病(OR=1.439,95%CI:1.241~1.669)与男性脑卒中高危人群颈动脉斑块形成风险较高有关;年龄增长(OR=1.058,95%CI:1.051~1.066)、不运动(OR=1.138,95%CI:1.001~1.294)、有脑卒中家族史(OR=1.201,95%CI:1.062~1.357)、明显超重或肥胖(OR=1.269,95%CI:1.127~1.430)、高血压(OR=1.169,95%CI:1.003~1.362)与女性脑卒中高危人群颈动脉斑块形成风险较高有关。结论 脑卒中高危人群颈动脉斑块形成的影响因素主要有年龄、脑卒中家族史、运动、明显超重或肥胖、高血压和糖尿病,且存在性别差异。Objective To explore the factors affecting carotid plaque formation among high-risk populations for stroke,so as to provide the reference for early intervention for carotid atherosclerosis among the populations.Methods Perma⁃nent residents were selected from Minhang District,Shanghai Municipality using the multi-staged cluster random sam⁃pling method from April to September 2021.Basic information,family history of stroke and past medical history were collected by the Community and Township Population Screening Scale for Cardiovascular and Cerebrovascular Disease Risk Factors.High-risk populations for stroke were identified according to the Technical Specifications for Stroke Screen⁃ing and Prevention.Carotid plaque status was assessed using carotid ultrasonography.Factors affecting carotid plaque for⁃mation were analyzed using a multivariable logistic regression model.Results Among the 25666 permanent residents surveyed,8459 were identified as high-risk populations for stroke,including 3362 males and 5097 females,with a male-to-female ratio of 0.66︰1.The median age was 66.00(quartile range,11.00)years.Carotid plaque were detected in 4305 cases among high-risk population for stroke,accounting for 50.89%.Multivariable logistic regression analysis showed that advanced age(OR=1.052,95%CI:1.043-1.061),family history of stroke(OR=1.297,95%CI:1.103-1.526),hypertension(OR=1.245,95%CI:1.025-1.512)and diabetes(OR=1.439,95%CI:1.241-1.669)were associated with a higher risk of carotid plaque formation in male high-risk population for stroke,advanced age(OR=1.058,95%CI:1.051-1.066),lack of exercise(OR=1.138,95%CI:1.001-1.294),family history of stroke(OR=1.201,95%CI:1.062-1.357),sig⁃nificant overweight or obesity(OR=1.269,95%CI:1.127-1.430)and hypertension(OR=1.169,95%CI:1.003-1.362)were associated with a higher risk of carotid plaque formation in female high-risk population for stroke.Conclusion The main influencing factors for carotid plaque formation among high-risk populations for stroke include age,family histo

关 键 词：脑卒中 颈动脉斑块 高危人群 影响因素 

分 类 号：R743[医药卫生—神经病学与精神病学] R543.4[医药卫生—临床医学]