脑卒中高危人群中脉压指数与颈动脉斑块关系的分析

目的在脑卒中高危人群中,探讨脉压指数(PPI)与颈动脉斑块的相关性,方法回顾性分析浙江省人民医院筛查出的813例脑卒中高危人群。根据有无颈动脉斑块分为无颈动脉斑块组和颈动脉斑块组,比较两组基线特征。根据PPI的水平将研究对象分为4组:Q1、Q2、Q3和Q4,比较各组间颈动脉斑块发生率。应用Logistic多因素回归对颈动脉斑块危险因素进行分析。结果与无颈动脉斑块组比较,颈动脉斑块组PPI增大(P=0.000)。随着PPI分层的升高颈动脉斑块发生率逐步上升(P=0.000)。Logistic多因素回归分析,表明年龄>70岁、男性、有糖尿病史、PPI分层是颈动脉斑块独立危险因素,年龄>70岁人且PPI分层为Q1、Q2、Q3和Q4的人群发生颈动脉斑块的风险是对照组的3.502、4.234、5.575和10.162倍(P=0.000,P=0.000、P=0.000和P=0.000)。男性且PPI分层为Q2、Q3和Q4的人群发生颈动脉斑块的风险是对照组的2.737、6.073和9.937倍(P=0.000、P=0.023和P=0.000)。有糖尿病史且PPI分层为Q2、Q3和Q4的人群发生颈动脉斑块的风险是对照组的2.287、3.288和8.944倍(P=0.00k P=0.000和P=0.001)。结论随着PPI升高,尤其是合并相关脑卒中危险因素的人群,发生颈动脉斑块的风险明显升高。

Objective To investigate the correlation between pulse pressure index(PPI)and carotid plaque in the high risk population of stroke.Methods 813 cases of high risk population of stroke screened by Zhejiang people's Hospital were analyzed retrospectively.According to the presence or absence of carotid plaque,the patients were divided into two groups:non-carotid plaque group and carotid plaque group,and the baseline characteristics of the two groups were compared.According to the level of PPI,the subjects were divided into four groups:Q1,Q2,Q3 and Q4.The incidence of carotid plaque was compared among groups.Logistic multivariate regression was used to analyze the risk factors of carotid plaque.Results Compared with the group without carotid plaque,the PPI of carotid plaque group was higher(P=0.000).With the increase of PPI stratification,the inci dence of carotid plaque increased gradually(P<0.01).Logistic multivariate regression analysis showed that age>70 years old,male,history of diabetes and PPI score were independent risk factors for carotid plaque.The risk of carotid plaque in the population with age>70 and PPI groups of Q1,Q2,Q3 and Q4 was 3.502,4.234,5.575 and 10.162 times higher than that in the control group(P=0.000,P=0.000,P=0.000 and P=0.000).The risk of carotid plaque in the population with men and PPI groups of Q2,Q3 and Q4 was 2.737,6.073 and 9.937 times higher than that in the control group(P=0.000,P=0.023 and P=0.000).The risk of carotid plaque in the population with a history of diabetes and PPI groups of Q2,Q3 and Q4 was 2.287,3.288 and 8.944 times higher than that in the control group(P=0.001,P=0.000 and P=0.001).Conclusion With the increase of PPI,especially in the population with related risk factors of stroke,the risk of carotid plaque is significantly increased.