高血压患者颈动脉斑块和急性缺血性脑卒中的相关性

An Analysis on Correlation between Carotid Plaque and Acute Ischemic Stroke in Essential Hypertension Patients

目的：探讨高血压患者颈动脉斑块与缺血性脑卒中的相关性.方法：原发性高血压（EH）患者180例,以是否伴有缺血性脑卒中（IS）包括脑梗死或短暂性脑缺血发作,分为缺血性脑卒中组（EH ＋IS,n=106）和单纯高血压组（EH,n=74）,超声检查两组颈动脉斑块有无、斑块部位、斑块性质、数量及颈动脉内膜中层（intima-media thickness,IMT）有无增厚,并进行比较;同时,以是否存在颈动脉斑块和是否发生脑卒中作为因变量,选择性别、年龄、尿酸、总胆固醇、血糖、HDL-C、CRP、叶酸、维生素B12、同型半胱氨酸、收缩压、舒张压作为自变量,进行相关分析.结果：EH＋ IS组与EH组比较,颈动脉斑块发生率明显增高（72.6％比43.2％,P=0.001）,两组比较差异有统计学意义（P＜0.01）.斑块发生的部位、形态、数量比较无统计学意义（P＞0.05）,IMT两组间无统计学意义（P＞0.05）;Logistic回归分析显示,年龄是颈动脉斑块形成的独立危险因素（β=0.068,OR=1.071,95％ CI=1.030 ～1.113,P=0.001）;颈动脉斑块增加缺血性脑卒中风险（OR=5.225,95％ CI =2.293 ～11.907,P=0.001）.结论：合并缺血性脑卒中的高血压患者颈动脉斑块发生率高于无脑卒中的高血压患者,颈动脉斑块形成是高血压患者发生脑卒中的独立危险因素.

Objective：To study the correlation between carotid plaques and cerebral ischemic stroke （IS） in essential hypertension patients.Methods：A total of 180 essential hypertension （EH） subjects were divided into group EH ＋ IS （n =106） and group EH （n =74） according to if the patients suffered cerebral infarction or IS simultaneously.Ultrasound was used to detect carotid artery plaque location,quality,number and carotid artery intima-media thickness （IMT）,and the correlation analysis was carried out.Results：The incidence of carotid artery plaque was significantly higher in group EH ＋ IS than that in group EH （72.6% vs 43.2%,P =0.001）.There was no difference in carotid artery plaque location,echo type,number and IMT between the two groups （P 〉 0.05）.Logistic regression analysis indicated that age was the independent risk factor of carotid plaque formation and carotid artery plaque increased the risk of IS in EH patients （OR =5.225,95 % CI =2.293 ～ 11.907,P =0.001）.Conclusions：Carotid artery plaque is associated with increased incidence of IS and is an independent risk factor of IS in EH patients.