缺血性卒中患者颈动脉粥样硬化斑块表面形态影响因素分析

Influencing Factors of the Surface Morphology of Carotid Atherosclerotic Plaque in Patients with Ischemic Stroke

目的颈动脉粥样硬化斑块被认为是导致急性脑血管事件可预测的影响因素,本研究探讨缺血性卒中患者颈动脉粥样硬化斑块表面形态的影响因素。方法选择2013年1—8月在安阳市人民医院神经内科住院治疗的缺血性卒中患者260例,采用彩色B超诊断仪行颈部血管超声检测,取每例患者直径最大的斑块并根据超声显示斑块表面形态的不同,分为:光滑型、不规则型、溃疡型3种类型,并记录性别、年龄、病程、吸烟史、高血压、高脂血症、糖尿病、既往是否有缺血性卒中病史及责任血管。采用多因素Logistic回归分析不同类型斑块的影响因素。结果多因素Logistic回归分析结果显示,高脂血症〔OR=0.338,95%CI(0.183,0.625),P=0.001〕与光滑型斑块有回归关系;高脂血症〔OR=0.469,95%CI(0.231,0.953),P=0.036〕与不规则型斑块有回归关系;高血压〔OR=0.443,95%CI(0.214,0.919),P=0.029〕、高脂血症〔OR=0.427,95%CI(0.192,0.953),P=0.038〕、糖尿病〔OR=2.628,95%CI(1.178,5.866),P=0.018〕与溃疡型斑块有回归关系。结论高血压是溃疡型斑块独立的影响因素,而高脂血症是各种类型斑块的独立影响因素,不同类型表面斑块的影响因素有共同影响因素,不同斑块表面形态也有各自独立的影响因素。

ObjectiveComplicated（irregularorulcerated）carotidplaqueisregardedasanindependentriskfactor of ischemic cerebrovascular disease .This study is to analyze the factors influencing the surface morphology of carotid atherosclerotic plaqueinpatientswithischemicstroke.Methods 260patientswithischemicstrokeadmittedtothedepartmentofneurologyof Anyang People′s Hospital from January to August in 2013 were selected.Carotid atherosclerotic plaque were detected by color Doppler ultrasound.The largest plaque of each patient was selected and in accordance with the surface morphology , the plaques were classified as smooth, irregular and ulcerated.The patients′sex, age, disease course, smoking history, hypertension, hyper-lipemia, diabetes and history of ischemic stroke were recorded .Multivariate Logistic regression analysis was used to analyze the in-fluencing factors for plaques .Results Multivariate Logistic regression analysis showed that hyperlipemia 〔OR=0.338, 95%CI （0.183, 0.625）, P=0.001〕 was risk factor for smooth plaques; Hyperlipemia 〔OR=0.469, 95%CI （0.231, 0.953）, P=0.036〕 was risk factor for irregular plaques; Hypertension 〔OR=0.443, 95%CI （0.214, 0.919）, P=0.029〕, hyperlipemia〔OR=0.427, 95%CI （0.192, 0.953）, P=0.038〕 and diabetes 〔OR=2.628, 95%CI （1.178, 5.866）, P=0.018〕 were risk factors for ulcerated plaques .Conclusion Hypertension is independent risk factor for ulcerated plaques and hyperlipemia is independent risk factor for all plaques .Different types of plaques may have common risk factors and different types of plaque mor-phology have their own risk factors .