颈动脉内—中膜厚度与缺血性卒中的相关性研究

发布时间：2018-03-14 08:35

本文选题：缺血性卒中　切入点：动脉粥样硬化　出处：《重庆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：背景和目的：相对于白种人来讲，亚洲地区人群颅内动脉粥样硬化病变的几率较颅外动脉高。同时由于两侧颈动脉存在解剖差异，因此推测左右两侧颈动脉内-中膜厚度与不同人群的脑卒中及其卒中亚型的相关性可能存在差异。本研究通过对我院缺血性卒中住院患者进行颈动脉内-中膜厚度（Carotid artery intia-media thickness，CIMT）与卒中类型的相关性分析，以及对颈动脉内-中膜厚度的危险因素进行分析，旨在揭示中国重庆地区人群缺血性卒中的特点。方法：采用回顾性研究方法，将2011.11-2012.10期间在我院神经内科因急性缺血性脑卒中住院的年龄＞45岁，病因可能为动脉粥样硬化患者纳为病例组。选择性别、年龄与之相匹配的因其他原因（除外血管原因）住院的患者纳为对照组。根据牛津社区卒中项目制定的脑卒中分型标准，将病例组分为前循环梗死组和后循环梗死组。通过对两侧CIMT、高血压、糖尿病、心脏病、吸烟、血脂、HsCRP等因素进行单因素分析及二元logistic回归分析来明确CIMT与脑卒中及其亚型的相关性。将CIMT分为增厚组和CIMT正常组，进一步比较两组间影响因素的差异性。结果：本研究发现，病例组和对照组中双侧CIMT、高血压、糖尿病、吸烟、饮酒、HDL、TG、HsCRP存在显著性差异（P＜0.05），通过logistic回归分析，发现LCIMT(OR6.104,P=0.001),高血压(OR2.122,P＜0.001)与脑卒中相关。在ACI和POCI两亚组的比较中，仅LDL存在统计学差异，双侧CIMT及其他相关因素均无差异。对于CIMT影响因素的分析，，本研究发现年龄和性别是CIMT的影响因素。结论：本研究发现LCIMT与脑卒中相关性较其他危险因素高，但CIMT与前循环梗死（Anterior circulation infarcts，ACI）和后循环梗死（Posterior circulation infarcts， POCI）两个亚型不相关。LDL与ACI的相关性可能较POCI更为密切。同时，年龄和性别是CIMT的重要影响因素。
[Abstract]:Background and objective: compared with white people, the risk of intracranial atherosclerosis in Asian population is higher than that in extracranial artery. Therefore, we speculate that there may be differences in the correlation between left and right carotid intima-media thickness and stroke and its subtype of stroke in different population. This study conducted carotid intima-media thickness in patients with ischemic stroke in our hospital. Analysis of the correlation between CIMT and stroke type in Carotid artery intia-media thicknessen, The risk factors of carotid intima-media thickness were analyzed in order to reveal the characteristics of ischemic stroke in Chongqing area of China. Methods: a retrospective study was conducted. The age of the patients hospitalized in the Department of Neurology for acute ischemic stroke in our hospital during the period from January 11 to October 2012 was more than 45 years old. The possible etiology of the disease was atherosclerotic patients as the case group. Sex was selected. Age-matched inpatients with other causes (except blood vessels) were included in the control group. Stroke classification criteria were established under the Oxford Community Stroke Project. The patients were divided into two groups: anterior circulation infarction group and posterior circulation infarction group. Univariate analysis and binary logistic regression analysis were performed to determine the correlation between CIMT and stroke and its subtypes. CIMT was divided into thickening group and normal CIMT group, and the difference of influencing factors between the two groups was further compared. Results: in this study, there was a significant difference in HsCRP between the two groups (P < 0.05). By logistic regression analysis, it was found that LCIMT OR6.104, OR 2.122, P < 0.001) was associated with stroke. In the two subgroups of ACI and POCI, there was a significant correlation between CIMT, hypertension, diabetes, smoking, and alcohol consumption (P < 0.05), and there was no significant correlation between the two subgroups (ACI and POCI), and there was no significant difference between the two subgroups (P < 0. 001, P < 0. 001, P < 0. 001). Only there was statistical difference in LDL, but there was no difference in bilateral CIMT and other related factors. Age and sex were found to be the influencing factors of CIMT for the analysis of the influencing factors of CIMT. Conclusion: in this study, the correlation between LCIMT and stroke is higher than other risk factors, but the relationship between CIMT and anterior circulation infarction (ACI) and posterior circulation infarction (POCII) is more closely related to ACI than that of POCI. Age and sex are important factors influencing CIMT.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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