马鞍山中年人群颈动脉病变的影响因素分析

Influencing factors of carotid artery lesion among middle-aged population in Ma'anshan City

目的探讨马鞍山地区中年人群颈动脉病变的主要影响因素,为当地预防和控制动脉粥样硬化提供依据。方法这是一个病例对照研究,共计468名参与者纳入本次研究,所有参与者均完成问卷调查、血生化检查及颈动脉超声检查,并根据颈动脉超声结果分成2组:病变组164例,男性91例,女性73例;平均年龄(50.35±5.14)岁;对照组304例,男性143例,女161例;平均年龄(50.49±4.89)岁。所有参与者都完成问卷及血生化。采用χ2检验分析生活习惯与颈动脉病变的关系,采用t检验分析血压、BMI及血生化指标与颈动脉的关系;并运用logistic回归方程分析颈动脉病变的主要影响因素。结果颈动脉病变组吸烟率、收缩压、BMI、低密度脂蛋白、载脂蛋B、脂蛋白α、空腹血糖、血清胱抑素C及同型半胱氨酸值高于对照组而高密度脂蛋白及载脂蛋白AI低于对照组;经logistic回归分析发现同型半胱氨酸、胱抑素C、脂蛋白α、高血糖、高血压及吸烟是马鞍山中年人群颈动脉病变的主要危险因素,其OR值分别为6.05、3.19、3.25、4.60、1.64和1.98。结论同型半胱氨酸、胱抑素C、脂蛋白α、高血糖、高血压、吸烟是马鞍山中年人群颈动脉病变的主要危险因素。

Objective To investigate the influence factors of Carotid artery lesion in the middle-aged population in Ma＇ anshan, so as to provide the evidences for the prevention and control of atherosclerosis. Methods The case-control study was conducted and 468 participants were enrolled. Each participant completed investigation and examination of blood bio- chemical and carotid ultrasonography. The subjects were divided into two groups according to the results of carotid ultra- sound. Lesion group ： 164 cases [ 91 male,73 female ; mean age （50. 35±5.14） years ] ; control group ：304 cases [ 143 men, 161 women;mean age （50.49 ± 4. 89）years 1. The Chi-square test and T-test were performed to examine the differences between the two groups of general population characteristics. T-test was used to examine the differences between the two groups of blood biochemical indices. The main influencing factors of carotid artery lesion were selected by Logistic regres- sion. Results When compared with the control group, the patients in the lesion group had higher smoking prevalence, and higher mean levels of systolic pressure, BMI, low density lipoprotein, apolipoprotein B, lipoproteinct, fasting plasma glu- cose, CysC and homocysteine, whereas lower mean levels of high-density lipoprotein and apolipoprotein A. Logistic regres- sion analysis showed that homocysteine, cystatin C, lipoprotein （a）, hyperglycaemia, hypertension and smoking were sub- stantial risk factors for carotid artery lesion, the odds ratios were 6.05,3.19,3.25,4.60, 1.64 and 1.98, respective- ly. Conclusion The high levels of homocysteine, cystatin C and lipoprotein（α）, hyperglycaemia, hypertension and smok- ing are the main risk factors for carotid artery lesion in Ma＇ anshan City.