颈动脉粥样硬化斑块与多重危险因素关系探讨

Association between carotid atherosclerotic plaque and multiple Risk Factors

目的探讨颈动脉粥样硬化斑块与多重心血管病危险因素的关系，评估危险因素对亚临床型靶器官损害，减少心血管病总体危险因素。方法选择2007年5月至2009年5月在我院门诊及病房住院的426例患者给予颈动脉彩色超声检查，根据检查结果分为颈动脉粥样硬化斑块组284例，颈动脉无粥样硬化斑块斑块组142例患者，分别记录年龄、吸烟、体重指数（BMI）、高血压、糖尿病、高脂血症病史。实验室检测血浆总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）、脂蛋白（a）[LP（a）]、载脂蛋白（ApoAl）、载脂蛋白（ApoB）、超高敏C-反应蛋白（hs—CRP）、同型半胱氨酸（HCY）、微量白蛋白尿（MAU）、血尿酸（UA）等，将自变量及单变量数据进行统计学处理，找出致颈动脉粥样硬化斑块的危险因素，并对结果进行分析。结果年龄、饮酒与颈总动脉内中膜（IMT）增厚相关（P〈0．001）。超重、糖尿病、LP（a）增高、高脂血症、年龄、MAU、HCY可独立预测颈动脉粥样硬化及斑块形成（χ2=71．35、38．45、t=3．26、χ2=37．23、t=118．51、6．723、3．17，P均〈0．05）危险因素个数聚集的多寡与IMT、颈动脉粥样硬化斑块独立相关（P=0．0001）。结论年龄、饮酒、超重、糖尿病、LP（a）增高、高脂血症、MAU、HCY是预测颈动脉粥样硬化及斑块形成的危险因素，并具有多重、聚集的特点，危险因素的个数越多，危险性越大。

Objective To investigate the relationship between carotid atherosclerotic plaque and multiple risk factors of angiocardiopathy, and to evaluate the injuries caused by different risk factors to subclinical target organ to control the general risk factors of angioeardiopathy. Methods Four hundred and twenty six outpatients and impatients, treated in our hospital from May 2007 to May 2009 with the results of color ultrasonic examination,were divided into carotid atherosclerotic plaque group （284 cases） and no carotid atheroselerotie plaque group（ 142 cases）. The clinical information including their age, body mass index, smoking condition, past medical history such as hypertension, diabetes mellitus and hyperlipoidemia were recorded, and the levels of total cholesterol（TC）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, triglyeeride （ TG）, lipoprotein （ a ） （ LP （ a ） ）, apolipoprotein A - 1 （ Apo A1 ）, apolipoprotein B （ Apo B ）, high- sensitivity C-reactive protein （hs-CRP） , homocysteine （HCY） , microalbuminuria （ MAU ） and urieacid （ UA ） were determined by lab tests. The independent variable and univariable data were processed and analyzed statistically to find out the risk factors of carotid atheroselerotic plaque. Results Age and drinking were significantly correlated with the carotid intima-media wall thickening （IMT） （ P 〈 0. 001 ）. Overweight, diabetes mellitus, increased LP （a）, hyperlipoidemia, age, increased MAU and HCY could independently predict carotid atherosclerosis and plaque formation （χ2 = 71.35,38.45, t = 3.26, X2 = 37. 23, t = 118.51,6. 723 and 3.17 respectively, PS 〈0. 05 ） . The aggregated number of the risk factors was correlated to IMT and carotid atherosclerotic plaque （ P = 0. 0001 ）. Conclusion Age, drinking, overweight, diabetes mellitus, increased LP （a） ,hyperlipoidemia, MAU and HCY are risk factors of carotid atheroselerosis and plaque formation, and the contribution of each factor can multiply and overlap, more risk factors means greater risk.