影响颈动脉粥样硬化易损斑块对称性分布的危险因素分析

Risk Factors Analysis for Symmetrical Distribution of Carotid Atherosclerotic Vulnerable Plaque

目的探讨影响颈动脉粥样硬化斑块对称性分布的危险因素。方法前瞻性入组81例缺血性卒中患者作为研究对象,均进行了颈动脉多对比序列、黑血、高分辨磁共振成像(magnetic resonance imaging,MRI)。根据MRI结果将患者分为颈动脉无易损斑块组(40例)、单侧易损斑块组(26例)和双侧易损斑块组(15例)。记录患者年龄、性别、高血压、糖尿病、目前吸烟史、血压值、脉压、体质指数(body mass index,BMI)和血脂水平等临床资料。采用Logistic回归分析颈动脉易损斑块形成的危险因素。结果单因素分析显示,无易损斑块组、单侧易损斑块组和双侧易损斑块组患者在高血压病史、目前吸烟史、体质指数、收缩压等方面差异具有显著性。多因素Logistic回归分析显示,目前吸烟史是易损斑块对称性分布的独立影响因素[比值比(odds ratio,OR)3.136,95%可信区间(confidence interval,CI)1.122~8.766,P=0.03]。结论目前吸烟史与颈动脉易损斑块的对称性分布有相关性。

Objective To investigate the risk factors affecting the symmetrical distribution of carotid atherosclerotic plaques. Methods A total of 81 patients with ischemic stroke patients were prospectively enrolled consecutively as the research subject, whom were performed with more comparative sequence, black blood and carotid artery high resolution magnetic resonance imaging （MRI）. According to the results of MRI, the patients were divided into 3 groups with no high risk vulnerable plaque group （n=40）, unilateral high risk vulnerable plaque group （n=26） and bilateral high risk vulnerable plaque group （n=15）. The clinical data of age, sex, hypertension, diabetes, current smoking history, blood pressure value, pulse pressure, BMI index and blood lipid level etc. were recorded. Logistic regression analysis was used to analyze the risk factors for carotid artery vulnerable plaque formation. Results Single factor analysis showed that there were statistically significant differences in hypertension history, current smoking history, BMI and systolic pressure in three groups （P〈0.05）. Multi-factors Logistic regression analysis showed that current smoking history （OR 3.136, 95%CI 1.122-8.766, P=0.03） was an independent factor for the occurrence of high risk vulnerable plaque and its symmetrical distribution. Conclusion There is correlation between current smoking history and the symmetrical distribution of carotid plaque. Smoking cessation might be good for the stability of plaque.