老年高血压患者颈动脉斑块检出率与缺血性脑卒中的相关性

Association between carotid artery plaque detection rate and ischemic cerebral stroke in elderly hypertension patients

目的探讨老年高血压患者颈动脉斑块检出率,评价颈动脉斑块与缺血性脑卒中患病率的相关性。方法收集2016年6月~2017年6月首都医科大学附属北京安贞医院心内科门诊就诊的老年高血压患者1690例,根据颈动脉超声结果分为颈动脉斑块组1143例,无颈动脉斑块组547例。收集研究对象性别、年龄、高血压病程、糖尿病、吸烟、饮酒、缺乏休闲活动等基本信息,测量血压和腰围,检测TC、LDL-C和空腹血糖,进行颈动脉超声检查。结果老年高血压患者颈动脉斑块检出率为67.6%。男性检出率明显高于女性(77.2%vs 62.7%,P<0.01);60~64岁、65~69岁以及≥70岁患者颈动脉斑块检出率分别为61.9%、71.3%和73.4%,随着年龄增长颈动脉斑块检出率增加(χ2=18.455,P趋势<0.01)。logistic回归分析显示,除性别和年龄外,高血压病程[OR=1.19,95%CI:1.05~1.35,P=0.006]、高TC血症(OR=1.43,95%CI:1.14~1.79,P=0.002)和饮酒(OR=1.62,95%CI:1.17~2.23,P=0.003)与颈动脉斑块发生显著相关。颈动脉斑块组与无颈动脉斑块组缺血性脑卒中患病率比较,差异无统计学意义(14.3%vs 12.2%,P=0.240)。调整相关因素的影响后,logistic回归分析显示,颈动脉斑块与高血压患者缺血性脑卒中无显著相关性(OR=1.09,95%CI:0.80~1.50,P=0.587)。结论老年高血压患者颈动脉斑块检出率高;颈动脉斑块检出率与老年高血压患者缺血性脑卒中患病率无明显相关性。

Objective To study the association between carotid artery plaque detection rate and ischemic cerebral stroke in elderly hypertension patients.Methods A total of 1690 elederly hypertension patients admitted to our hospital from June 2016 to June 2017 were divided into carotid plaque group(n=1143) and carotid plaque-free group(n=547) according to their carotid ultrasonography.Their baseline data, such as gender, age, course of hypertension and DM,history of smoking and alcohol consumption, lack of leisure activities were recorded.Their blood pressure, waist circumference, serum levels of TC,LDL-C and fasting blood glucose were measured.Their carotid plaques were detected by carotid artery ultrasonography.Results The carotid plaque detection rate was 67.6% in elderly hypertension patients and was significantly higher in male hypertension patients than in female hypertension patients(77.2% vs 62.7%,P<0.01).The carotid plaque detection rate was 61.9%,71.3% and 73.4% respectively in patients aged 60-64 years, 65-69 years and ≥70 years, and increased with their increasing age(χ2=18.455,P<0.01).Logistic regression analysis showed that duration of hypertension, hypercholesterolemia and alcohol consumption were closely associated with carotid artery plaques in elderly hypertension patients(OR=1.19,95%CI:1.05-1.35,P=0.006;OR=1.43,95%CI:1.14-1.79,P=0.002;OR=1.62,95%CI:1.17-2.23,P=0.003).No significant difference was detected in incidence of ischemic cerebral stroke between the two groups(14.3% vs 12.2%,P=0.240).Logistic regression analysis also showed that carotid artery plaques were not closely associated with ischemic cerebral sroke after adjustment for relevant factors(OR=1.09,95%CI:0.80-1.50,P=0.587).Conclusion The high detection rate of carotid artery plaques is not closely associated with the incidence of ischemic cerebral stroke in elderly hypertension patients.