颈动脉粥样硬化斑块稳定性影响因素分析

Analysis of factors influencing the stability of carotid atherosclerotic plaque

目的探讨分析颈动脉粥样硬化斑块稳定性的影响因素。方法选取住院的160例颈动脉粥样硬化斑块患者作为研究对象,根据颈动脉彩色多普勒超声检查结果将患者分为稳定组(82例)和不稳定组(78例)。收集2组患者的一般临床资料分别进行单因素分析,并采用多因素logistic回归分析探讨影响颈动脉粥样硬化斑块稳定性的危险因素。结果160例颈动脉粥样硬化斑块患者中稳定斑块82例,不稳定斑块78例,斑块不稳定率为48.75%。比较2组患者性别、年龄、吸烟史、饮酒史、高血压史、γ-谷氨酰转肽酶(GGT)、尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、同型半胱氨酸(HCY)等影响因素,单因素分析显示不稳定组患者GGT、UA、HCY水平均显著高于稳定组(P<0.05)、男性患者占比显著高于稳定组(P<0.05),HDL水平显著低于稳定组(P<0.05);多因素logistic回归分析显示,高水平GGT(OR=1.037、95%CI值1.006~1.070)、高水平HCY(OR=1.125、95%CI:1.043~1.215)为颈动脉粥样硬化斑块不稳定的独立危险因素。结论颈动脉粥样硬化斑块不稳定性较高,其中高水平GGT和高水平HCY与不稳定斑块的发生密切相关。

ObjectiveTo investigate the factors affecting the stability of carotid atherosclerotic plaque.Methods A total of 160 patients with carotid atherosclerotic plaque were selected as the research objects.According to the results of carotid color doppler ultrasound,the patients were divided into stable group(82 cases)and unstable group(78 cases).The general clinical data of the two groups were collected for univariate analysis,and multivariate logistic regression analysis was used to analyze the risk factors affecting the stability of carotid atherosclerotic plaque.Results Among 160 patients with carotid atherosclerotic plaque,82 patients had stable plaque and 78 patients had unstable plaque,and the plaque instability rate was 48.75%.Single factor analysis showed that:the levels of GGT,UA and HCY in unstable group were significantly higher than those in stable group(P<0.05),the proportion of male patients was significantly higher than that in stable group(P<0.05),and the level of HDL was significantly lower than that in stable group(P<0.05).Multivariate logistic regression analysis showed that high GGT(OR=1.037,95%CI 1.006~1.070)and high HCY(OR=1.125,95%CI 1.043~1.215)were independent risk factors for carotid atherosclerotic plaque instability.Conclusion The incidence of instability in carotid atherosclerotic plaques is high,and high levels of GGT and HCY are closely related to the occurrence of unstable plaques.