颈动脉溃疡斑块与症状性缺血性卒中的相关性及危险因素分析

Association of symptomatic ischemic stroke with ulcerated plaques in carotid artery and the risk factors

目的探讨颈动脉溃疡斑块与症状性缺血性卒中的相关性,及颈动脉溃疡斑块的危险因素。方法选择2014年8月至2015年2月在我院住院的63例有颈动脉粥样硬化斑块的脑梗死患者,根据有无缺血性卒中症状,分为症状组和无症状组,行脑血管造影检查。再根据有无溃疡斑块,将所有患者分为溃疡组和无溃疡组,结合临床资料,进行单因素分析和多因素分析。结果颈动脉溃疡斑块在症状组的发生率为40.74%,无症状组为16.67%,两组间差异具有统计学意义（P〈0.05）。糖尿病（OR=4.716;95%CI1.286-17.291;P=0.019）和高同型半胱氨酸（OR=1.068;95%CI1.002-1.139;P=0.043）与颈动脉溃疡斑块密切相关。结论颈动脉溃疡斑块在症状性缺血性卒中组发生率较高,糖尿病和高同型半胱氨酸是颈动脉溃疡斑块的独立危险因素。

Objective To explore the association of symptomatic ischemic stroke with ulcerated plaques in carotid artery and the risk factors.Methods We selected63 patients with ischemic stroke who were hospitalized in the First Affiliated Hospital of Xi＇an Jiaotong University Health Science Center from August 2014 to February2015.All the patients were confirmed to have carotid plaques by carotid ultrasound examination.According to clinical symptoms,they were divided into two groups：one group with symptom of ischemic stroke and the other without the symptom.All the patients received cerebral angiography to compare the occurrence rate of carotid atherosclerotic plaques and ulcerated plaques in carotid artery between the two groups.Then according to the DSA results,they were divided into two groups.The clinical data for the 63 patients were summarized.Logistic regression was used to analyze the data in each single factor analysis and multi-factor analysis.Results The occurrence rate of ulcerated plaques in the group of symptomatic ischemic stroke and the group of asymptomatic ischemic stroke was 40.74% and16.67%,respectively,with significant difference（P〈0.05）.The homocysteine（OR=1.068,95% CI 1.002-1.139,P=0.043）and diabetes（OR =4.716,95% CI 1.286-17.291,P=0.019）were associated with the occurrence of ulcerated plaques in carotid artery.Conclusion The occurrence rate of ulcerated plaques was higher in the group of symptomatic ischemic stroke than in the group of asymptomatic ischemic stroke.High-homocysteine and diabetes were the important risk factors for ulcerated plaques in carotid artery.