血脂与颈动脉斑块形成的临床关联研究

Clinical Association between Blood Lipid and the Formation of Carotid Plaque

目的:研究血脂与颈动脉斑块形成之间的临床关联。方法:收集2005年6月-2006年12月在本院检查颈动脉彩色多普勒超声的住院患者279例,分析其临床资料,先对颈总动脉的内膜-中层厚度(IMT)行多重回归、根据颈动脉有无斑块进行分组并行二项分类Logistic回归筛选其影响因素,再分析血脂四项指标与颈动脉的斑块积分、斑块指数及IMT之间的偏相关性分析,并比较有无斑块两组血脂四项指标的大小。并对血脂四项指标绘制ROC曲线评价其对颈动脉斑块的预测价值。结果:在对IMT的多重回归中低密度脂蛋白(LDL)被作为危险因素之一筛选出来(B=0.055,P=0.048),但在二项分类Logistic回归中血脂四项指标均被剔除。LDL与IMT之间呈正相关(r=0.120,P=0.048)。颈动脉有无斑块两组间血脂四项指标无统计学意义。四项指标的ROC曲线下面积均小于0.7(P均>0.05),对有无斑块形成没有预测价值。结论:LDL与颈动脉的IMT增厚有关,但血脂四项指标与颈动脉斑块的形成不平行,对颈动脉有无斑块形成没有预测价值。

Objective： To explore the clinical association between blood lipids and the formation of carotid plaques. Methods： Clinical data of 279 in-patients who underwent color Doppler uhrasonography of cervical artery in our hospital between June 2005 and December 2006 were analyzed. Firstly, muhinomial regression was used to screen for factors related to the intima - media thickness （IMT） of carotid artery, and binary logistic regression was used to screen for factors related to formation of carotid plaques. The correlations among four parameters of blood lipids, Crouse scores and indices of carotid plaque and the IMT of carotid artery were then assessed using partial correlation analysis, and the four parameters of blood lipids were compared between groups with and without carotid plaques. Finally, receiver operating characteristic （ROC） curves of the four parameters of blood lipids were used to predict the presence of carotid plaque. Results： In the multinomial regression model of IMT, low density llpoprotein （LDL） was identified as a risk factor （B = 0. 055, P = 0. 048） , while in the binary logistic regression model, all of the four parameters of blood lipids were excluded. Positive correlation was shown between LDL and IMT （r = 0. 120, P = 0. 048 ）. NO statistical difference in the four parameters of blood lipid was found between groups with and without carotid plaques. The area under ROC curves of the four blood lipid parameters was less than 0.7 （ all P 〉 0.05） , indicating that these blood lipid parameters may not be staficient to predict the presence of carotid plaques. Conclusion： There is a correlation between LDL and the IMT of carotid artery. Lack of parallelity between the four blood lipid parameters and formation of carotid plaques suggests that these parameters may not be predictive of carotid plaques.