客家人群颈动脉闭塞的临床特点及相关危险因素分析

Analysis of clinical characteristics and risk factors for carotid artery occlusion in Hakka population

目的分析客家人群颈动脉闭塞的临床特点,并分析其相关危险因素。方法选取我院收治的120例颈动脉闭塞患者及同期收治的120例非颈动脉闭塞的患者为研究对象,回顾性分析所有研究对象颈CTA、头颅MRI+MRA检查结果及甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血糖(Glu)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)、糖化血红蛋白(HbA1c)等相关血生化指标,探讨客家人群颈动脉闭塞的临床特点及相关危险因素。结果 120例客家人群颈动脉闭塞患者中,前循环缺血表现93例(77.5%),后循环缺血8例(6.67%),无症状19例(15.83%),差异有统计学意义(P<0.05);其中后交通动脉开放89例,前交通动脉开放45例,差异有统计学意义(P<0.05)。颈动脉闭塞患者性别、年龄、TC、TG、LDL-C、HDL-C、CRP、HbA1c、Hey水平、冠心病病史、高血压史、糖尿病史与非颈动脉闭塞患者相比差异具有统计学意义(P<0.05);LDL-C、Hcy、HbA1c、糖尿病史、高血压史、冠心病病史六项因素属于影响客家人群颈动脉闭塞相关危险因素。结论客家人群颈动脉闭塞以前循环系统缺血表现为主,主要表现为偏瘫、失语、偏身感觉障碍、头痛、发作性单眼盲(黑蒙);少数后循环缺血的临床表现为反复头晕或突发晕厥;后交通动脉为其主要代偿方式;LDL-C、Hcy、HbA1c、糖尿病史、高血压史、冠心病病史六项因素属于影响客家人群颈动脉闭塞相关危险因素,在颈动脉闭塞中发挥重要作用。

Objective To analyze the clinical characteristics and risk factors of carotid artery occlusion in Hakka population. Methods Totally 120 cases with carotid artery occlusion admitted to our hospital and another 120 cases without carotid artery oc- clusion were selected as study subjects, whose outcomes of CT angiography （CTA） of cervical arteries, brain MRI and brain MRA and the levels of triglyceride （TG）,total cholesterol （TC） ,low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, blood glucose （G1u）, homocysteine （Hcy）, C-reactive protein （CRP） and glycosylated hemoglobin （HbAlc） and other related blood biochemical indexes were retrospectively analyzed in order to investigate the clinical characteristics and re- lated risk factors of carotid artery occlusion in Hakka people. Results Of the 120 cases with carotid artery occlusion, 93 cases （77.5%） presented anterior circulation ischemia, 8 cases （6.67%） presented posterior circulation ischemia and 19 cases （15.83%） had no symptoms,which showed no statistical differences （P〉0.05）. Among 120 cases,there were 89 cases with the opening of posterior communication artery and 45 cases with the opening of anterior communication ai＇tery,which showed statistieally significant difference （Pal0.05）. There were statistical differences in gender, age, the levels of TG, LDL-C, HDL-C, CRP, HbAlc and Hcy and the histories of coronary heart disease,hypertension and diabetes mellitus between patients with carotid artery occlusion and patients without carotid artery occlusion （P ~0.05）. In addition, the levels of Hcy, HbAlc and LDL-C, diabetes, hy- pertension and coronary heart disease were responsible for the related risk factors for carotid artery occlusion. Conclusion Firstly, carotid artery occlusion in Hakka population mainly presents the manifestations of anterior circulation isehemia including hemiple- gia,aphasia, hernidysesthesia, headache and transient monocular blindness. Secondly, a few clinical manifestations of posterior cir- culation ischemia contain recurrent dizziness or sudden syncope. Thirdly,posterior communication artery may be the crucial com- pensation approach. Last but not least, the levels of H cy, HaAlc and LDL-C, diabetes, hypertension and coronary heart disease which are risk factors of carotid artery occlusion,play important roles in carotid artery occlusion.