脑卒中患者血管危险因素与颈动脉粥样硬化的关系

目的研究脑卒中患者血管危险因素与颈动脉粥样硬化的关系。方法受试者151人主要为脑梗死及椎-基底动脉供血不足病例。将所有受试对象行颈动脉超声检查,采用二分类变量的Logistic回归分析方法对其危险因素进行筛选,找出与颈动脉粥样硬化改变相关的因素。结果年龄及吸烟与颈动脉内中膜增厚之间存在相关性,P=0.006（OR=1.08,95%CI 1.02-1.14）和0.01（OR=5.09,95%CI 1.47-17.61）;年龄、吸烟同样与颈动脉斑块之间存在相关性,P=0.006（ORn=n1.06,95%CI 1.06-1.11）和0.04（ORn=2.97,95%CI 1.04-8.50）,收缩压与颈动脉斑块呈正相关,P=0.04（OR=1.03,95%CI 1.00-1.05）,舒张压与颈动脉斑块呈负相关P=0.04（OR=0.96,95%CI 0.92-1.00）。结论随年龄的增大动脉内中膜增厚及颈动脉斑块的患病率增加,吸烟者内中膜增厚及颈动脉斑块比率高于不吸烟者;收缩压增加颈动脉斑块患病率增加,舒张压增加斑块患病率下降。

Association between Vascular Risk Factors and Carotid Atherosclerosis in Stroke Patients

Objective To study the role of vascular risk factors in stroke patients, with reference to carotid artery atherosclerosis. Methods One hundred and fifty one cases of cerebral infarction and vertebro-basilar artery insufficiency （ 141 men and 10 women）were included in this study and divided into two groups： experimental group and control group, according to the results of ultrasonic examination of carotid artery. Binary logistic regression analysis was used to access the association between carotid artery atherosclerosis and vascular risk factors, and Enter method was used to collect covariates. Results Ageing and smoking were associated with the prevalence of artery intima-media thickening, with a P values of 0.006 （OR = 1.08,95 % CI 1.02- 1.14） and 0.01 （OR = 5.09,95 % CI 1.47 - 17.61）, respectively. Meanwhile, ageing and smoking were associated with the prevalence of carotid atherosclerotic plaques, and the P values were 0.006 （OR = 1.06,95% CI 1.06 - 1.11） and 0.04 （OR = 2.97, 95% CI 1.04 - 8.50）, respectively. The increase of systolic blood pressure would lead to elevating the prevalence of carotid atherosclerotic plaques, P = 0.04 （OR = 1.03, 95%CI 1.00 - 1.05）. It was found that diastolic blood pressure had an inverse correlation with the prevalence of carotid atherosclerotic plaques, P = 0.04 （OR = 0.96, 95 % CI 0.92-1.00）. Conclusions The morbidity of carotid artery atherosclerosis, both artery intima-media thickening and plaques formation, is raising as ageing, and be higher in the smoking population. In addition, increased systolic blood pressure may result in more plaques of carotid artery atherosclerosis, while diastolic blood pressure may decrease its prevalence. However, the association between blood pressure and carotid artery atherosclerosis is still uncertain.