脑梗死患者颈动脉硬化程度与特征及其相关危险因素分析

Analysis of the degree and characteristics of carotid atherosclerosis in patients with cerebral infarction

目的分析脑梗死患者颈动脉硬化程度与特征及其相关危险因素。方法选择2015年10月到2018年10月收治的符合纳入标准的脑梗死患者156例为观察组,根据超声检测结果分为斑块组与无斑块组,同时对斑块组患者的斑块稳定性又分为稳定斑块组与不稳定斑块组。选择同期住院的非脑梗死患者100例为对照组。分析不同组患者的颈动脉硬化程度与特征及其相关危险因素。结果观察组颈动脉超声检测颈动脉粥状硬化检查率为83.33%,明显高于对照组的13.00%(P>0.05)。颈动脉斑块组患者在年龄、吸烟史、饮酒史(酗酒)、糖尿病、高脂血症、高血压>140/90mmHg、HHcy>15μmol/L、LP-PLA2的临床特征水平明显高于无颈动脉斑块组(P <0.05)。颈动脉粥状硬化患者稳定斑块组在高血压>140/90mmHg、HHcy>15μmol/L以及LP-PLA2明显高于不稳定斑块组(P <0.05)。经多因素Logisitic分析,结果显示年龄、吸烟、HHcy>15μmol/L、高血压>140/90mmHg、高脂血症、LP-PLA2是影响脑梗死颈动脉硬化的独立危险因素(P <0.05)。结论脑梗死患者颈动脉硬化程度较高,存在斑块比例也较高,而年龄、吸烟、HHcy、高血压、高脂血症、LP-PLA2均是影响脑梗死颈动脉硬化的独立危险因素。

Objective To analyze the degree and characteristics of carotid atherosclerosis and related risk factors in patients with cerebral infarction.Methods 156 patients with cerebral infarction who met the inclusion criteria from October 2015 to October 2018 were selected as observation group.According to the results of ultrasound examination,they were divided into plaque group and plaque-free group.At the same time,the plaque stability of patients in the plaque group was divided into stable plaque group and unstable plaque group,100 patients with noncerebral infarction who were hospitalized during the same period were selected as the control group.The degree and characteristics of carotid atherosclerosis and related risk factors were analyzed in different groups of patients.Results The carotid atherosclerosis examination rate in the observation group was 83.33%,which was significantly higher than that in the control group(13.00%)(P>0.05).The clinical characteristics of age,smoking history,drinking history(alcoholism),diabetes,hyperlipidemia,hypertension>140/90 mmHg,HHcy>15μmol/L,and LP-PLA2 were significantly higher in the carotid plaque group.There was no carotid plaque group(P<0.05).The stable plaque group in patients with carotid atherosclerosis was significantly higher than the unstable plaque group with hypertension>140/90 mmHg,HHcy>15μmol/L and LP-PLA2(P<0.05).Multivariate Logisitic analysis showed that age,smoking,HHcy>15μmol/L,hypertension>140/90 mmHg,hyperlipidemia,and LP-PLA2 were independent risk factors for carotid atherosclerosis in cerebral infarction(P<0.05).Conclusion Cervical arteriosclerosis is higher in patients with cerebral infarction,and the proportion of plaque is higher.Age,smoking,HHcy,hypertension,hyperlipidemia,and LP-PLA2 are independent risk factors for carotid atherosclerosis in cerebral infarction.