脑梗死患者颈动脉斑块形成与血尿酸、性别、年龄、糖尿病史等相关因素的回归分析

Regression analysis of carotid plaques in patients with cerebral infarction and related risk factors including blood uric acid, sex, age and diabetes

目的:分析脑梗死患者高尿酸血症与颈动脉斑块之间的关系。方法:选择清华大学第一附属医院神经内科2003-08/2004-10的住院脑梗死患者126例,均经CT和(或)MRI证实。根据颈动脉彩色超声检查的结果,发现颈动脉斑块的患者归为斑块组(n=68),未发现斑块的患者归为对照组(n=58)。比较两组血尿酸水平,以及高尿酸血症的发生率(男>420μmol/L,女>340μmol/L),同时比较其他可能的危险因素包括性别、年龄、吸烟、酗酒、高血压、糖尿病、血脂、脑卒中家族史等。危险因素的选择、混杂因素的控制及交互作用的判断用Logistic回归模型分析计算比值比(OR)及其95%可信区间(CI),应用SPSS10.0软件进行统计分析。结果:①斑块组患者的年龄以及高血压、糖尿病的发生率均显著高于无斑块的患者[(67.0±8.2),(59.1±10.9)岁,P=0.001;86.8%,72.4%,P=0.044;38.2,20.7%,P=0.033]。②两组血尿酸水平比较差异不显著[(330.97±109.73),(311.28±101.96)μmol/L,P=0.299],斑块组高尿酸血症发生率高于对照组,但差异无统计学意义(27.94%,13.79%,P=0.061)。③反向条件Logistic回归分析显示年龄、糖尿病、高尿酸血症以及酗酒进入回归方程,除酗酒外均有统计学意义,高尿酸血症、年龄、糖尿病对于颈动脉斑块的OR值分别为2.829,1.100和2.753,P值分别为0.001,0.049,0.033。结论:高尿酸血症、年龄和糖尿病可能为脑梗死患者颈动脉斑块形成的独立危险因素。

AIM： To study the association between hyperuricacidemia and the occurrence of carotid plaques in the patients of cerebral infaction. METHODS： Totally 126 inpatients admitted in the Department of Neurology, the First Affiliated Hospital of Tsinghua University from August 2003 to October 2004 were included, They were diagnosed as cerebral infarction by CT and/or MRI, and grouped as plaque group （n=68） and control group （n=58） according to the results of duplex color Doppler. Those detected with plaques in carotid artery were classified as plaque group, whereas those without any plaque were clarified as controls. The patients of two groups were compared in the level of blood uric acid, the incidence of hyperuricacidemia （male〉420μmol/L, female 〉 340μmol/L） and other possible risk factors including age, sex, drinking, smoking, hypertension, diabetes, serum lipid, family stoke history, Logistic regression model was applied in the screening risk factors, effect of mixed factors and interaction. The odd ratio （OR） and 95% confidence intervals （CI） were calculated. Statistical analysis was carried out by the software SPSS 10.0, RESULTS： ①The mean age and the incidences of hypertension and diabetes were significantly higher in the patients with carotid plaques than in patients without plaque [（67.0±8.2）, （59.1±10.9） years old, P=0.001, 86.8%, 72.4%, P=-0.044： 38.2%, 20.7%, P=0.033]. ②No significant difference of the mean value of blood uric acid was found between two groups [（330.97±109.73）, （311.28±101.96）μmol/L, P=0.299]. The incidence of hyperurieaeidemia was higher in plaque group than in control group, but there was no significant difference （27.94%, 13.79%, P=0.061）,③Logistie regression analysis showed that age, diabetes, drinking and hyperurieaeidemia were involved in the regression equation. The ORs of age, diabetes and hyperurieaeidemia for carotid plaques were 1,100 （P=0.001）, 2.753 （P=-0.049） and 2.829 （P=-0.033） respectively, CONCLUSION： Hyperurieaeidemia, age, and diabetes are the possible independent risk factors for carotid plaque in the patients of cerebral infarction.