下肢动脉粥样硬化的超声检查及其危险因素分析

发布时间：2018-05-14 08:53

本文选题：下肢动脉硬化 + 危险因素　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：通过彩色多普勒超声检测技术检测样本人群双下肢动脉情况以讨论讨论下肢动脉硬化疾病（Lower Extremity Atherosclerotic Disease, LEASD）的临床发病特点，回顾性分析LEASD与可能的危险因素如性别、年龄、吸烟、饮酒、血压、血糖、血脂及身体质量指数等的相关性；以筛出LEASD的高危因素而服务于临床预防工作。方法：随机抽取2012年1月—2014年1月于吉林大学中日联谊医院门诊进行超声检查的患者351人作为研究对象，通过彩色多普超声检查待检者双下肢动脉，将下肢动脉分为动脉正常组与LEASD组（包括部分动脉管壁增厚者；部分节段斑块形成尚未引起管腔狭窄或闭塞者；动脉管腔不规则狭窄者、按照病情严重程度分为轻度、中度、重度；动脉部分节段管腔闭塞者），分别记录LEASD的发生部位、病变程度等。运用SPSS19.0统计软件对计数资料行X2检验，以P0.05为具有统计学差异；对性别、年龄、吸烟、饮酒、血压、血糖、血脂及身体质量指数等LEASD可能的危险因素进行统计学分析，首先采用X2检验，以P0.05为具有统计学差异，，而后纳入多因素Logistic回归分析，进而选出具有统计学意义的高危影响因素。结果： 1.351例人群中下肢动脉情况：动脉正常者130例（37.03%），部分动脉管壁增厚者7例（1.99%），斑块形成尚未引起管腔狭窄或闭塞者186例（52.99%），动脉管腔不规则狭窄者共计13例（3.70%）；其中按轻度、中度、重度分级例数依次为:2例、3例、8例，动脉部分节段管腔闭塞者15例（4.27%）。 2.该样本量351人中LEASD病变发生部位：累及股总动脉111条；累及股浅动脉96条；累及乆动脉102条；累及胫前动脉95条；累及足背动脉161条；累及胫后动脉68条。 3.该样本量351人中LEASD单独累及动脉节段：单独累及股总动脉20条，单独累及股浅动脉10条；单独累及乆动脉9条；单独累及足背动脉44条；单独累及胫后动脉2条。 4.部分节段斑块形成尚未引起管腔狭窄或闭塞者186人中斑块累及部位：累及股总动脉80条；累及股浅动脉63条；累及乆动脉74条；累及胫前动脉68条；累及足背动脉137条；累及胫后动脉48条。 5.本样本351例人群中LEASD伴糖尿病患者共计70人，该70人中LEASD累及动脉情况：累及股总动脉34条；累及股浅动脉34条；累及乆动脉37条；累及胫前动脉41条；累及足背动脉54条；累及胫后动脉33条。 6.以LEASD为因变量，以性别、年龄、吸烟、饮酒、血压、血糖、血脂及身体质量指数等为自变量，分别进行X2检验，得出男性、增龄、吸烟、高血压、高血糖是LEASD的危险因素（P0.05）。将男性、增龄、吸烟、高血压、高血糖因素行多因素非条件Logistic逐步回归分析显示男性、增龄、高血糖具有高危险度。结论： 1.男性、增龄、吸烟、高血压、高血糖是LEASD的危险因素。 2.男性、增龄、高血糖是LEASD形成独立高危因素。 3.饮酒、高血脂、BMI尚不能认为是LEASD的危险因素 4. LEASD最常累及部位为足背动脉 5.应用彩色多普勒超声技术对下肢动脉进行扫查，有助于临床对LEASD病变的早期诊断及病程评估，彩色多普勒超声是一项无创、便捷、准确、价廉的LEASD筛查的检查手段。
[Abstract]:Purpose :

The relationship between LEASD and possible risk factors such as sex , age , smoking , alcohol consumption , blood pressure , blood sugar , blood lipid and body mass index were analyzed retrospectively .
To screen the high risk factors of LEASD and serve for clinical prevention .

Method :

In January 2012 - January 2014 , 351 patients who underwent ultrasonic examination at the outpatient department of Sino - Japanese Friendship Hospital in Jilin University were randomly selected as the subjects . The arteries of the lower limbs of the subjects were examined by color Doppler ultrasound , and the lower limbs were divided into the normal group and the LEASD group ( including partial artery wall thickening ) .
part of the segmental plaque formation has not resulted in stenosis or occlusion of the lumen ;
Patients with irregular arterial lumen stenosis were classified as mild , moderate and severe according to the severity of the disease ;
The incidence of LEASD and the degree of lesion were recorded by SPSS 10.0 statistical software .
The risk factors of LEASD such as sex , age , smoking , alcohol consumption , blood pressure , blood sugar , blood fat and body mass index were analyzed statistically .

Results :

Among the 351 cases , there were 130 cases ( 37.03 % ) in the middle and lower extremities , 7 cases ( 1.99 % ) of partial arterial wall thickening , 186 cases ( 52.99 % ) with stenosis or occlusion of the plaque , and 13 cases ( 3.70 % ) of the irregular stenosis of the arterial lumen .
Among them , there were 2 cases , 3 cases , 8 cases , and 15 cases ( 4.27 % ) .

2 . The lesion of LEASD occurred in 351 people in the sample size : 111 of total femoral artery ;
96 cases involving superficial femoral artery ;
102 of the progressive artery ;
95 of anterior tibial artery ;
161 cases involving the dorsal artery of the foot ;
68 strips of posterior tibial artery .

3 . The total number of LEASD in 351 patients was involved in the arterial segment : 20 of the total femoral artery were involved , and 10 of the superficial femoral artery were involved alone ;
Nine of the individual progressive arteries were involved .
44 cases involving the dorsal artery of the foot alone ;
2 cases of posterior tibial artery were involved .

4 . Part of the segmental plaque formation has not caused plaque accumulation in 186 patients with stenosis or occlusion of the lumen : 80 of the total artery of the femoral artery ;
63 cases involving superficial femoral artery ;
74 of the progressive artery ;
68 of anterior tibial artery ;
137 cases involving the dorsal artery of the foot ;
48 cases involving posterior tibial artery .

5 . Of the 351 patients , there were 70 patients with LEASD with diabetes mellitus .
34 cases involving superficial femoral artery ;
37 cases involving the progressive artery ;
41 cases involving anterior tibial artery ;
54 cases involving the dorsal artery of the foot ;
33 cases involving posterior tibial artery .

6 . Using LEASD as the dependent variable , the sex , age , smoking , alcohol consumption , blood pressure , blood sugar , blood fat and body mass index were used as independent variables , and X2 test was carried out to obtain the risk factors of male , aged , smoking , hypertension and hyperglycemia ( P0.05 ) .

Conclusion :

1 . Men , age , smoking , hypertension , hyperglycemia are a risk factor for LEASD .

2 . Male , age , hyperglycemia were independent high risk factors for LEASD .

3 . Drinking , hypolipidemic and BMI could not be considered as a risk factor for LEASD .

4 . The most common part of LEASD is the dorsal artery .

5 . Using the color Doppler ultrasound technique to scan the lower extremity artery , it is helpful for the early diagnosis and the course assessment of LEASD lesion , and the color Doppler ultrasound is a non - invasive , convenient , accurate and cheap LEASD screening method .

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R543.5;R445.1

【参考文献】