摘要
目的探讨急性缺血性脑卒中患者形成颈动脉粥样硬化（carotid atherosclerosis,CAS）的相关因素。方法选取2014-01-01-11-30常德市第一人民医院神经内科的急性缺血性脑卒中住院患者290例。经颈动脉彩超检查,将内-中膜厚度（intima-media thickness,IMT）〉1.2mm或有斑块者定义为CAS,据此分为CAS组（218例）和无CAS组（72例）。收集两组患者年龄、性别、高血压史、糖尿病史、吸烟史、饮酒史等一般资料以及检测三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、极低密度脂蛋白（VLDL）、血清尿酸（UA）、纤维蛋白原（FIB）、C反应蛋白（CRP）、同型半胱氨酸（Hcy）水平等血液学指标,对上述指标中单因素分析差异有统计学意义（P〈0.05）者,进行多因素二元Logistic回归分析,分析其与CAS形成的相关性。结果单因素分析显示,高血压、糖尿病、吸烟史以及年龄、TC、LDL、FIB、CRP、Hcy差异具有统计学意义（P〈0.05）;多因素Logistic回归分析显示,糖尿病（OR=3.144,95%CI：1.305~7.575,P=0.011）、高血压（OR=2.029,95%CI：0.945~4.358,P=0.070）、吸烟史（OR=1.852,95%CI：0.941~3.643,P=0.074）以及FIB（OR=1.480,95%CI：0.928~2.35,P=0.100）、TC（OR=1.40,95%CI：1.050~1.868,P=0.022）、年龄（OR=1.045,95%CI：1.005~1.067,P=0.021）、CRP（OR=1.159,95%CI：1.062~1.266,P=0.001）、Hcy（OR=1.061,95%CI：0.996~1.131,P=0.068）均为CAS形成的危险因素,其中高血压、糖尿病、吸烟史以及TC、FIB水平作用强度较大。结论高血压、糖尿病、吸烟史以及年龄、TC、FIB、CRP、Hcy是CAS形成的危险因素,糖尿病、高血压、吸烟史以及FIB、TC作用强度较大。
Objective To investigate the risk factors of carotid atherosclerosis in patients with acute ischemic stroke.Methods Two hundred and ninety patients with acute ischemic stroke were selected from January to November in 2014 in the department of neurology,the First People＇s Hospital of Changde.According to the results of ultrasonograhy,carotid intima-media thickness（IMT1.2mm）or atherosclerotic plaque were defined as CAS,and then the selected patients were divided into the CAS group（218cases）and the No CAS group（72cases）.Various parameters of blood were detected,such as Triglyceride（TG）,total cholesterol（TC）,low density lipoprotein（LDL）,high density lipoprotein（HDL）,very low density lipoprotein（VLDL）,uric acid（UA）,fibrinogen（FIB）,C-reactive protein（CRP）,and homocysteine（Hcy）.General information was aslo collected,such as age,sex,the history of hypertension,diabetes,smoking and drinking.Those data were analyzed by univariate analysis and binary logistic regression to obtain the related factors of CAS and evaluate the effect intensity to CAS.Results Univariate analysis showed there were significant statistical differences（P 〈0.05）in hypertension,diabetes,smoking,age,TC,LDL,FIB,CRP,and Hcy;logistic regression indicated the odds ratio（OR）of those items were larger than others,which included diabetes（OR=3.144,95% CI：1.305-7.575,P=0.011）,hypertension（OR=2.029,95% CI：0.945-4.358,P=0.070）,smoking（OR=1.852,95% CI：0.941-3.643,P=0.074）,FIB（OR=1.480,95% CI：0.928-2.359,P=0.100）,TC（OR=1.401,95% CI：1.050-1.868,P=0.022）and age（OR=1.045,95% CI：1.005-1.067,P=0.021）,CRP（OR=1.159,95% CI：1.062-1.266,P=0.001）,Hcy（OR=1.061,95% CI：0.996-1.131,P=0.068）.Conclusions Hypertension,diabetes,smoking,age,TC,FIB and Hcy are the related factors of CAS and the effect intensity of diabetes,hypertension,smoking,FIB and TC is larger than others.
出处
《中国神经免疫学和神经病学杂志》
CAS
2015年第2期117-120,共4页
Chinese Journal of Neuroimmunology and Neurology
作者简介
通讯作者：刘运海，Email：yunhail@163．com.
