缺血性脑卒中患者颈动脉粥样硬化斑块危险因素的分析

Risk Factors of Carotid Artery Atherosclerosis: Plaque in Ischemic Stroke Patients

目的探讨缺血性脑卒中颈动脉粥样硬化斑块形成的危险因素。方法将148例缺血性脑卒中患者,经颈动脉彩超检查分为有斑块组80例和无斑块组68例。分别检测颈动脉内膜-中层厚度(IMT)、血糖、血压、血脂、纤维蛋白原、C-反应蛋白、胰岛素样生长因子-1,先进行单因素比较,然后进行非条件logistic多元回归分析。结果斑块组年龄、颈动脉IMT、总胆固醇、低密度脂蛋白、纤维蛋白原、C-反应蛋白水平及高血压、糖尿病比例高于无斑块组(P≤0.05);logistic多元回归分析表明,C反应蛋白(OR=3.546,P=0.035)、纤维蛋白原(OR=1.074,P=0.012)是颈动脉粥样硬化斑块形成的最危险因素。结论在缺血性脑卒中,颈动脉IMT增厚可反应颈动脉硬化程度;高龄、高血压、高血糖、高脂血症、纤维蛋白原增高、C-反应蛋白增高可能是颈动脉粥样硬化斑块形成的危险因素;C-反应蛋白、纤维蛋白原在颈动脉粥样硬化斑块的发生发展中起了重要作用。

Objective To explore the risk factors of carotid artery atherosclerotic plaque in ischemic stroke patients. Methods One hundred and forty-eight patients with ischemic stoke were allocated into two groups by ultrasonographic testing （80 with plaque and 68 without plaque）. The carotid artery acoustic densitometry （IMT）, blood pressure, blood glucose, blood lipid, fibriongen （FIB）, c-reactive protein （CRP） were tested. First, single variable analysis was conducted and then multivariate noncondition stepwise logistic model analysis was conducted. Results Carotid IMT, age , total cholesterol （TC）, low density lipoprotein （LDL）-CH, FIB, CRP level and the incidence of hypertension and diabetes were significantly higher in ischemic stroke patients with carotid artery plaques than patients without plaques （P≤0.05）; Multiple logistic regression analysis showed the most important risk factors of plaques were CRP （OR=3.546, P=0.035） and FIB （OR=1.074, P=0.012） level. Conclusion The main risk factors of carotid atherosclerosis plaque are almost the same as atherosclerosis, such as age , hypertension ,diabetes, hyperlipidemia, high FIB and CRP level and increase in carotid IMT. CRP and FIB may play a crucial role in the development of carotid artery atherosclerosis plaque.