颈动脉不稳定型斑块、血脂、血压与急性脑梗死关系的病例对照研究

Case-control study on association of carotid artery unstable carotid plaque,blood lipid and blood pressure with acute cerebral infarction

目的探讨颈动脉不稳定型斑块、血脂、血压与急性脑梗死之间的关系。方法行彩色多普勒超声检查了解颈动脉斑块性质,同时对比血脂、血压水平,采用病例对照研究设计比较脑梗死组与对照组之间的差异。结果与对照组比较,脑梗死组斑块检出率高于对照组(2=12.477,P<0.001);且不稳定斑块占脑梗死组检出斑块的70.2%,差异均有统计学意义(2=7.754,P=0.005)。脑梗死患者总胆固醇、甘油三酯、极低密度脂蛋白胆固醇及低密度脂蛋白胆固醇高于对照组,高密度脂蛋白胆固醇低于对照组,差异均有统计学意义(均有P<0.05)。两组检出有不稳定斑块者的高密度脂蛋白胆固醇低于无斑块者、低密度脂蛋白胆固醇高于无斑块者,差异均有统计学意义(均有P<0.05)。脑梗死组收缩压及舒张压均高于对照组,差异有统计学意义(均有P<0.05)。研究对象中既往有高血压病史者中,脑梗死组收缩压和舒张压均高于对照组(t1=3.154,P1=0.003;t2=4.384,P2<0.001),差异有统计学意义。结论急性脑梗死的发病与颈动脉不稳定型斑块、血脂、血压有相关关系,在危险因素出现早期进行积极的干预治疗,对于降低急性脑梗死发病率可能有重要意义。

Objective To investigate the relationship between carotid artery unstable plaque,blood lipid,blood pressure and the acute cerebral infarction. Methods Color doppler ultrasound was conducted to see the nature of carotid plaque. At the same time,the blood lipid and blood pressure levels of two groups were compared,case-control study design was used to compare the differences between the cerebral infarction group and the control group. Results Compared with the control group,the detection rate of carotid plaque in the cerebral infarction group was higher（x^2= 12. 477,P〈0. 001）; and unstable plaques occupied 70. 2% of the cerebral infarction group detected plaques（x^2= 7. 754,P = 0. 005）,differences were statistically significant. TC,TG,VLDL and LDL-C of the cerebral infarction group was higher than that of the control group,and HDL-C was lower than that of the control group,differences were statistically significant（ all P〈0. 05）. As for the patients detected with unstable plaques,their HDL-C was lower than that of people without plaques and LDL-C was higher than those without plaques,differences were statistically significant（ all P〈0. 05）. Systolic blood pressure and diastolic blood pressure of the cerebral infarction group were both higher than that of the control group,differences were statistically significant（ all P〈0. 05）. Among the study objects with high blood pressure history,the systolic and diastolic pressure of the cerebral infarction group were higher than that of the control group（ t1= 3. 154,P1= 0. 003; t2=4. 384,P2 0. 001）,differences were statistically significant. Conclusions The occurrence of acute cerebral infarct is related to carotid artery unstable carotid plaques,blood lipid and blood pressure. Positive prevention treatment in the early stage of risk factors has potential significance in reducing acute cerebral infarct occurrence rate.