代谢综合征对脑梗死后颈动脉粥样硬化进程的影响

Influence by metabolic syndrome on carotid atherosclerosis progression after cerebral infarction

目的探讨代谢综合征(MS)对于脑梗死患者颈动脉粥样硬化进展过程的影响。方法 150例脑梗死患者,根据是否合并MS分成MS组和NMS(non-MS)组,各75例。同时选取人口学资料具可比性的75例健康成人作为对照组。比较三组相关代谢指标、颈动脉内-中膜厚度、粥样硬化检出情况和斑块积分,分析MS和颈动脉粥样硬化之间的相关性。结果 1 MS组体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、斑块检出率、颈动脉内膜中层厚度(IMT)、左侧血管内径、右侧血管内径、左侧阻力指数(RI)和右侧RI显著高于NMS组和对照组,且NMS组显著高于对照组,差异具有统计学意义(P<0.05);2 Logistic分析显示年龄(β=0.037,P<0.05)、MS(β=0.081,P<0.01)、高TC(β=0.021,P<0.05)、高TG(β=0.061,P<0.01)、高LDL-C(β=0.073,P<0.01)均为动脉粥样硬化的独立危险因素。结论 MS作为颈动脉粥样硬化的独立危险因素之一,能够促使脑卒中患者颈动脉粥样硬化进展,增加病情恶化风险。

Objective To investigate influence by metabolic syndrome(MS)on carotid atherosclerosisprogression after cerebral infarction.Methods A total of150patients with cerebral infarction were divided bywhether with complicated MS into MS group and non-MS(NMS)group,with75cases in each group.There wereanother75healthy people with comparable data as control group.Comparison was made on related metabolismindex,carotid intima-medial thickness,atherosclerosis detection condition and plaque scores in the three groups.Correlation between MS and carotid atherosclerosis was analyzed.Results①MS group had all obviously higherbody mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterin(LDL-C),detection rate of plaque,carotid intimamedialthickness(IMT),left blood vessel diameter,right blood vessel diameter,left resistance index(RI)andright RI than NMS group and the control group,and NMS group also had higher indexes than the control group.Their difference had statistical significance(P<0.05).②Logistics analysis showed age(β=0.037,P<0.05),MS(β=0.081,P<0.01),high TC(β=0.021,P<0.05),high TG(β=0.061,P<0.01),and high LDL-C(β=0.073,P<0.01)as independent risk factors for atherosclerosis.Conclusion As one of the independent risk factors foratherosclerosis,MS can accelerate carotid atherosclerosis progression in cerebral infarction patients and increaserisk of exacerbation.