超声颈动脉定量参数对H型高血压患者脑卒中风险的评估价值

Value of quantitative parameters of carotid artery under ultrasound for evaluating stroke risk in patients with H-type hypertension

目的:探讨超声颈动脉定量参数在评估H型高血压患者罹患脑卒中风险中的应用价值。方法:收集2016年3月至2018年6月某院住院治疗的高血压患者200例,根据患者血清同型半胱氨酸(Hcy)浓度分为H型高血压组(H组,Hcy浓度≥10μmol/L)和非H型高血压组(NH组,Hcy浓度<10μmol/L),其中H组118例、NH组82例。比较2组患者的超声颈动脉参数[内-中膜厚度(intima-media thickness,IMT)、斑块大小和检出率]和生化指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)]。采用SPSS 20.0软件进行数据分析。采用Pearson相关分析进行变量间的相关性分析,通过多因素Logistic回归分析方法分析相关指标与脑卒中的关系。结果:H组颈动脉IMT、斑块厚度、斑块检出率均高于NH组,差异有统计学意义(P均<0.05);2组斑块的长轴长度和短轴长度及TG、TC、HDL及LDL比较差异无统计学意义(P均>0.05)。颈动脉IMT厚度与血清Hcy浓度、年龄呈显著正相关(r=0.152、0.252,P<0.05),与HDL呈显著负相关(r=-0.136,P<0.05)。Hcy浓度增高、H型高血压、颈动脉斑块厚度增加、IMT增高是脑卒中发生的危险因素,具有预测价值(P<0.05)。结论:超声颈动脉定量参数(颈动脉IMT值、斑块厚度)对评估H型高血压患者发生脑卒中的风险具有一定的价值。

Objective To investigate the application value of quantitative parameters of carotid artery under ultrasound for evaluating the risk of stroke in patients with H-type hypertension.Methods Two hundred patients with hypertension treated in some hospital from March 2016 to June 2018 were collected.According to the level of serum homocysteine(homocysteine,Hcy)on admission,the patients were divided into two groups:type H hypertension group(Hcy concentration≥10μmol/L)and non-H type hypertension group(Hcy concentration<10μmol/L).There were 118 cases in the type H hypertension group and 82 ones in the non-H type hypertension group.The two groups were compared for carotid ultrasound parameters including intima-media thickness(IMT),plaque thickness and detection rate and for biochemical indexes including total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL)and low-density lipoprotein(LDL).SPSS 20.0 software was used for data analysis.Pearson analysis was applied to correlation discussion between variables,and multifactorial Logistic regression analysis was used to analyze the relationship between relevant indicators and stroke.Results Carotid IMT,plaque thickness,and plaque detection rate were all higher in type H hypertension group than in non-H type hypertension group,and the differences were statistically significant(P<0.05);there were no statistically significant differences in the long-axis length and short-axis length of plaques and in the comparison of TG,TC,HDL,and LDL between the 2 groups(P>0.05).Carotid IMT thickness was significantly positively correlated with serum Hcy concentration and age(r=0.152 and 0.252,P<0.05),and significantly negatively correlated with HDL(r=-0.136,P<0.05).Increased Hcy concentration,H-type hypertension,increased carotid plaque thicknes sand increased IMT were risk factors for stroke occurrence and had predictive value(P<0.05).Conclusion The carotid ultrasound parameters such as carotid IMT and plaque thickness are of great value for evaluating the stroke risks for the patients with type H hypertension.