南充地区体检者颈动脉粥样斑块形成的相关危险因素分析

Study on the risk factors of carotid atherosclerotic plaque formation in healthy physical examinators in nanchong area

目的探讨颈动脉斑块形成的相关危险因素,为动脉粥样硬化的零级预防及一级预防提供依据。方法收集2018年1月至2019年1月在川北医学院附属医院健康管理中心进行健康体检并进行了颈部血管彩超检查的所有受检者10707例,其中男性6597例,年龄(50.42±12.24)岁;女性4110例,年龄(48.61±12.14)岁。按照颈动脉血管彩超结论分为颈动脉斑块组、颈动脉增厚组、颈动脉正常组。分组比较不同的颈部血管彩超结果下的体质量指数(BMI)、收缩压、舒张压、胆红素、三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、同型半胱氨酸、尿酸、血糖、脉压差、年龄、性别是否存在差异。综合评估颈部血管斑块形成的相关危险因素。结果颈动脉正常组、颈动脉斑块组、颈动脉增厚组BMI[(24.22±3.22)、(24.56±2.97)、(24.3±3.33)kg/m2]、收缩压[(121.78±16.42)、(134.25±19.78)、(126.01±17.12)mmHg]、舒张压[(74.68±11.79)、(80.9±11.75)、(77.04±11.63)mmHg]、胆红素[(15.73±6.01)、(16.04±6.02)、(15.8±5.68)μmol/L]、三酰甘油[(1.71±1.55)、(1.8±1.81)、(1.67±1.28)mmol/L]、总胆固醇[(5.00±0.90)、(5.30±1.00)、(5.16±0.90)mmol/L]、低密度脂蛋白[(2.79±0.77)、(3.13±3.13)、(2.92±0.81)mmol/L]、同型半胱氨酸[(10.62±4.07)、(11.51±4.12)、(10.85±4.22)μmol/L]、尿酸[(344.27±93.95)、(356.82±89.31)、(341.52±87.12)μmol/L]、血糖[(5.16±1.22)、(5.89±9.44)、(5.33±1.33)mmol/L]、脉压差[(47.03±9.16)、(51.75±16.10)、(48.97±9.76)mmHg]、年龄、性别在不同的颈部血管彩超结果间差异有统计学意义(P<0.05)。以颈部血管彩超结果正常为参照组,性别是发生斑块的保护因素,女性发生斑块的风险比男性低;年龄越大,形成斑块的风险越高;胆红素含量是发生斑块的保护性因素;收缩压越高,斑块形成的风险越大;低密度脂蛋白胆固醇含量越高,斑块形成的可能性越大,空腹血糖含量越高,斑块形成的风险也越高。结论年龄、性别、体质指数、收缩压、低密度脂蛋白胆固醇是颈部血管斑块形成的独立危险因素。胆红素是颈部血管斑块形成的保护性因素。明确斑块形成的危险因素对颈部血管斑块形成的零级预防及一级预防具有重要意义。

Objective To explore the related risk factors of carotid plaque formation,and to provide a good basis for the zero-grade prevention and primary prevention of atherosclerosis.Methods From January 2018 to January 2019,10707 subjects who underwent physical examination in the affiliated health management center of north sichuan medical college were collected,All the 10707 patients underwent color ultrasound examination of neck blood vessels.Among them,there were 6597 males with an average age of(50.42±12.24)years.The mean age of 4110 females was(48.61±12.14)years.According to the conclusion of carotid artery ultrasound,it was divided into:carotid plaque group;carotid artery thickening group;normal carotid artery group.Results Body mass index(BMI)[(24.22±3.22),(24.56±2.97),(24.3±3.33)kg/m^2],systolic blood pressure[(121.78±16.42),(134.25±19.78),(126.01±17.12)mmHg],diastolic blood pressure[(74.68±11.79),(80.9±11.75),(77.04±11.63)mmHg],bilirubin[(15.73±6.01),(16.04±6.02),(15.8±5.68)μmol/L],triglyceride[(1.71±1.55),(1.8±1.81),(1.67±1.28)mmol/L],total cholesterol[(5.00±0.90),(5.30±1.00),(5.16±0.90)mmol/L],low-density lipoprotein[(2.79±0.77),(3.13±3.13),(2.92±0.81)mmol/L],homocysteine[(10.62±4.07),(11.51±4.12),(10.85±4.22)μmol/L],uric acid[(344.27±93.95),(356.82±89.31),(341.52±87.12)μmol/L],blood glucose[(5.16±1.22),(5.89±9.44),(5.33±1.33)mmol/L],pulse pressure difference[(47.03±9.16),(51.75±16.10),(48.97±9.76)mmHg],age,gender in normal carotid artery group,carotid plaque group andcarotid artery thickening group were different in the results of neck vascular ultrasound(P<0.05).For neck vascular exceeds the normal control group,the protection of the gender is plaque factors,risk of plaques in women less than men;Older you get,the greater the risk of a buildup of plaque bilirubin content is plaque protective factors;The higher systolic blood pressure,the greater the risk that the plaque formation;Low density lipoprotein cholesterol content is higher,the greater the chance of plaque formation,fasting blood sugar content is higher,the higher the risk of the plaque formation.Conclusion Age,sex,BMI,systolic blood pressure and LDL cholesterol are independent risk factors for the formation of neck vascular plaque.Bilirubin is a protective factor for the formation of cervical vascular plaque.It is of great significance to clarify the risk factors of plaque formation for zero-grade prevention and primary prevention of neck vascular plaque formation.