便携式三维超声在中老年人颈动脉斑块筛查 的应用和斑块形成的危险因素分析

Application of portable three-dimensional ultrasound in screening carotid plaque in middle-aged and elderly people and analysis of risk factors of carotid plaque

目的探讨便携式三维超声在中老年人颈动脉斑块筛查的临床价值,并分析斑块形成的危险因素。方法以横截面研究的方式纳入2019年3月至2019年6月海军军医大学附属长征医院血管外科的门诊患者,对328例年龄≥50岁的人群分别进行便携式颈动脉三维超声和传统颈动脉血管彩超检查,采用问卷调查形式记录相关信息,并根据有无颈动脉斑块分为斑块组和正常组,分析斑块形成的危险因素。结果三维超声和颈动脉彩超均检查出颈动脉斑块阳性患者185例,筛查阳性率56.4%。多因素Logistic回归分析发现吸烟(OR=3.821,P=0.001)、高血压(OR=2.690,P=0.001)、糖尿病(OR=2.614,P<0.001)、高脂血症(OR=2.368,P=0.001)、BMI分级(OR=1.293,P=0.034)、年龄(OR=1.056,P=0.001)是颈动脉斑块发生的危险因素。结论便携式三维超声更加简单高效,在颈动脉斑块筛查具有重要的应用价值。吸烟,高血压、糖尿病、高脂血症、肥胖、高龄是颈动脉斑块发生的危险因素。

Objective To evaluate the application of portable three-dimensional ultrasound in screening carotid plaque in middle-aged and elderly people,and to analyze the risk factors of carotid plaque.Methods A cross-sectional survey was conducted among patients from outpatient clinic of Vascular Surgery,Changzheng Hospital Affiliated to Naval Military Medical University from March to June 2019.328 cases who≥50 years old were screened by portable three-dimensional ultrasound and traditional carotid artery color Doppler ultrasound.Questionnaire surveys were used to record relevant information.Patients were divided into plaque group and normal group according to the presence or absence of carotid plaque.Risk factors of carotid plaque were analyzed.Results 185 patients were screened positive for carotid plaque by both portable three-dimensional ultrasound and carotid artery color Doppler ultrasound.The positive rate was 56.4%.Multivariate logistic regression analysis showed that smoking(OR=3.821,P=0.001),hypertension(OR=2.690,P=0.001),diabetes(OR=2.614,P<0.001),hyperlipidemia(OR=2.368,P=0.001),BMI classification(OR=1.293,P=0.034)and elderly(OR=1.056,P=0.001)are the risk factors for carotid plaque.Conclusion Portable three-dimensional ultrasound is simpler and more efficient,and has important application value in carotid plaque screening.Smoking,hypertension,diabetes,hyperlipidemia,obesity and elderly are the main risk factors for carotid atherosclerotic plaque.