探讨颈动脉粥样硬化斑块的形成及稳定性的危险因素

发布时间：2018-10-20 13:44

【摘要】：目的:应用彩色多普勒对颈动脉斑块进行筛查,探讨颈动脉斑块形成的危险因素及影响斑块稳定性的因素。方法:150例受检者行颈动脉彩色多普勒超声超声检查,检测出颈动脉粥样硬化斑块92例,应用Logistic回归分析筛选出差异有统计学意义的各变量及各变量发生颈动脉粥样硬化斑块的优势比(OR),评价各变量对颈动脉粥样硬化斑块形成的危险性。根据斑块的超声特点进一步分为稳定性斑块及不稳定性斑块,进行多因素Logistic回归分析,得出具有统计学意义的指标。结果:通过颈动脉斑块形成的单因素回归分析得出,年龄、高血压史、糖尿病史、甘油三脂(TG)、低密度脂蛋白(LDL)、C反应蛋白(CRP)等与颈动脉斑块的形成密切相关,进一步做多因素Logistic回归,得出年龄、高血压史、糖尿病史是颈动脉斑块形成的独立危险因素(P0.05),其中OR值从大到小依次为糖尿病史(OR值为4.842)、年龄(OR值为0.946)及高血压史(OR值为0.542)。糖尿病史的OR值最高,说明有糖尿病史者得颈动脉斑块的风险最高。通过对颈动脉斑块稳定性的多因素回归分析得出,CRP是影响斑块稳定性的危险因素,同时通过Spearsman相关分析进一步得出CRP与颈动脉斑块的稳定性呈正相关(相关系数为0.734,P:0.000),即CRP越高,斑块越不稳定。结论:颈动脉彩色多普勒超声因其无创性、经济、便捷、易于重复等优点,可作为反映动脉粥样硬化程度的一个“窗口”。通过对颈动脉斑块进行筛查,并分析斑块的稳定性,指导我们结合临床及各项实验室指标探讨引起颈动脉斑块的危险因素,从而间接评估心血管疾病发生的潜在风险,减少心血管意外的发生。
[Abstract]:Objective: to investigate the risk factors of carotid plaque formation and the factors affecting plaque stability by color Doppler imaging (CDFI). Methods: one hundred and fifty cases of carotid artery atherosclerotic plaques were examined by color Doppler ultrasonography, 92 cases of carotid atherosclerotic plaques were detected. The risk of carotid atherosclerotic plaque formation was evaluated by Logistic regression analysis among the variables and the predominance of each variable in carotid atherosclerotic plaques compared with (OR), in evaluating the risk of carotid atherosclerotic plaque formation. According to the ultrasonic characteristics of plaques, the stable plaques and unstable plaques were further divided into stable plaques and unstable plaques. The multivariate Logistic regression analysis was carried out, and a statistically significant index was obtained. Results: univariate regression analysis showed that age, history of hypertension, history of diabetes, triglyceride (TG), low density lipoprotein (LDL), C reactive protein (CRP) were closely related to carotid plaque formation. Further multivariate Logistic regression showed that age hypertension history and diabetes history were independent risk factors for carotid plaque formation (P0.05) in which the OR values were diabetes history (OR = 4.842) age (OR = 0.946) and hypertension history (OR = 0.542). OR was the highest in diabetes history, suggesting that people with diabetes had the highest risk of carotid plaque. By multivariate regression analysis of carotid plaque stability, CRP was found to be a risk factor for plaque stability. At the same time, by Spearsman correlation analysis, a positive correlation between CRP and carotid plaque stability was obtained (correlation coefficient was 0.734p: 0.000), that is, the higher the CRP was, the higher the plaque stability was. The more unstable the plaque. Conclusion: carotid color Doppler ultrasound can be used as a window to reflect the degree of atherosclerosis because of its advantages of noninvasive, economical, convenient and easy to repeat. By screening carotid plaques and analyzing the stability of carotid plaques, we can explore the risk factors of carotid plaques in combination with clinical and laboratory indicators, so as to indirectly assess the potential risk of cardiovascular disease. Reduce cardiovascular accidents.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R743.3

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