急性缺血性脑血管病患者代谢综合征与颈动脉粥样硬化的相关性研究

Correlation study of metabolic syndrome and carotid atherosclerosis in patients with acute ischemic cerebrovascular diseases

目的 探讨急性缺血性脑血管病（AICD）患者颈动脉粥样硬化（CA）的特点以及代谢综合征（MS）对CA的影响.方法 应用彩色多普勒超声仪检查514例AICD患者及300例对照组的颈动脉,比较两组颈动脉内中膜厚度（IMT）、斑块指数、CA发生率及MS患病率.按是否有CA将AICD患者分成CA组及非CA组,分析两组MS的患病率以及MS和其单一组分危险因素与CA的相关性.结果 （1）AICD组MS患病率、IMT、斑块指数及CA发生率均明显高于对照组,比较差异有统计学意义（P〈0.05）.（2）CA组MS、高血压、三酰甘油（TG）增高、低密度脂蛋白胆固醇（LDL-C）增高及总胆同醇（TC）增高的发生率高于非CA组,比较差异有统计学意义（P〈0.05）.（3）调整年龄、性别、吸烟史和其他单一组分危险因素后,MS依然增加CA患病的危险,其OR值为2.43.95%CI为1.81～3.96.（4）伴糖尿病的MS患者CA的患病危险度（OR值为22.46）是不伴糖尿病的MS患者的5.6倍（OR值为3.98）.结论 AICD患者MS及CA患病率高,MS是CA的独立危险因素,并和其各单一组分危险因素及糖尿病相互作用促进CA的发生.

Objective To investigate the characteristics of carotid atherosclerosis （CA） in patients with acute ischemic cerebrovascular disease （AICD） and explore the relation between metabolic syndrome （MS） and CA. Methods Color Dopple ultrasound was used to examine the carotid artery of 514 patients with AICD and 300 healthy subjects as control group. The intima-media thickness （IMT） of common carotid artery, carotid plaque index, the occurrence rate of CA and the prevalence of MS were compared between the 2 groups. Patients with AICD were divided into CA group and non-CA group according to the occurrence situation of CA; the prevalence of MS and the correlation between MS and single risk factor were analyzed. Results The prevalence of MS, IMT, carotid plaque index and the occurrence rate of CA in the AICD group were all significantly higher than those in the control group （P〈0.05）. The prevalence of MS, and the incidence of hypertension and high levels of triglyceride （TG）, low-density lipoprotein cholesterol （LDL-C）, and total cholesterol （TC） in the CA group were significantly increased than those in the non-CA group. After age, gender and smoking adjusted and further adjusted component risk factors of MS, the MS defined by CDS criteria was associated with a 1.81 to 3.96 fold high risk of the CA. The risk of CA in patients with MS accompanied with diabetes was 5.6 times higher than that in patients with MS alone. Conclusion The prevalence of MS and CA in patients with AICD was high. The MS was positively associated with the risk of CA and cooperated with its component risk factors or diabetes to further impact CA.