下肢动脉硬化闭塞与无症状性颈动脉狭窄的相关性研究

Correlation between arteriosclerosis obliterans and asymptomatic carotid stenosis

目的探讨无症状性颈动脉狭窄(asymptomatic carotid stenosis,ACS)与下肢动脉粥样硬化闭塞(arteriosclerosis obliterans,ASO)的临床关系。方法收集2013年10月至2015年10月间在天津市人民医院血管外科以下肢动脉粥样硬化闭塞入院的患者共200例。患者分为重度ACS组(狭窄率≥70%)和非重度ACS组(狭窄率<70%)。结果重度ACS组患者的年龄、吸烟、饮酒、血脂水平和纤维蛋白原水平与非重度ACS组相比较差异有统计学意义(P<0.05)。重度ACS的发生率随下肢ASO严重程度加重而逐渐增加(x^2=28.2,P<0.05)。下肢ASO患者随着年龄的增加,重度ACS的发生率亦增加(x^2=7.78,P<0.05)。多因素Logistic回归分析显示高龄(OR:1.079,95%CI:1.055~1.104,P<0.05),高脂血症(OR:2.013,95%CI:1.076~3.325,P<0.05)是重度ACS预测指标。结论随着下肢ASO患者年龄增大、病变严重程度加重,重度ACS的发病率呈上升趋势。高脂血症以及高龄是重度ACS的潜在危险因素。

Objective To evaluate the relationship between asymptomatic carotid stenosis (ACS) and lower limb arteriosclerosis obliterans (ASO).Methods 200 patients with lower extremities arteriosclerosis obliterans who were admitted in our hospital between Oct 2013 and Oct 2015 were retrospectively reviewed.Patients were divided into severe ACS (stenosis≥70%)and moderate ACS (stenosis <70%).Results Compared with moderate ACS,the severe ACS patients were elder,heavier cigarette-smoker and alcohol drinker,higher hypertriglyceride and fibrinogen level (all P <0.05).The incidence rate of severe ACS increased as lower limb ASO gets more significant (x^2=28.2,P<0.05).It also increased with age (x^2=7.78,P <0.05).Multi-factor logistic regression showed advanced age (OR:1.079,95%CI:1.055-1.104,P<0.05)and hypertriglyceride (OR:2.013,95%CI:1.076-3.325, P<0.05)were risk factors for severe ACS.Conclusions The incidence of severe ACS increased with the increasing of age and severity of lower limb ASO.Advanced age and hypertriglyceride were potential risk factors for severe ACS.