急性缺血性卒中患者颈动脉易损性斑块的临床分布特点及危险因素分析

发布时间：2018-03-21 23:00

本文选题：卒中　切入点：斑块　出处：《解放军医学杂志》2016年09期 　论文类型：期刊论文

【摘要】：目的分析急性缺血性卒中(AIS)患者颈动脉斑块的分布特点,探讨颈动脉易损性斑块的危险因素。方法收集兰州大学第二医院神经内科2014年3月-2015年2月收治的588例AIS患者及性别、年龄匹配的630例非脑卒中患者的临床资料,分析两组颈动脉斑块的分布规律;根据颈部血管超声检查结果将AIS患者分为无斑块组(247例)、稳定斑块组(93例)、易损斑块组(248例),比较3组患者的临床资料,并进行多因素logistic回归分析以确认颈动脉易损性斑块的独立危险因素。结果 AIS组和对照组颈动脉斑块检出率分别为57.99%、50.95%,其中易损性斑块检出率分别为42.18%、33.81%,AIS组颈动脉斑块和易损性斑块检出率均高于对照组,差异有统计学意义(P0.05)。颈动脉不同斑块组间年龄、男性比例、高血压、糖尿病及收缩压比较差异有统计学意义(P0.05),多因素logistic回归分析显示年龄(OR=1.043,95%CI 1.027~1.061,P=0.000)、男性(OR=1.973,95%CI 1.377~2.828,P=0.000)、糖尿病(OR=1.454,95%CI1.004~2.106,P=0.047)、收缩压(OR=1.011,95%CI 1.002~1.020,P=0.016)是AIS患者颈动脉易损性斑块的独立危险因素。结论颈动脉易损性斑块破裂、脱落继发栓塞可导致AIS的发生;年龄、性别、糖尿病和收缩压是AIS患者颈动脉易损性斑块的独立危险因素。
[Abstract]:Objective to analyze the distribution of carotid plaques in patients with acute ischemic stroke and to explore the risk factors of carotid plaque vulnerability. Methods 588 patients with AIS and their sex were collected from March 2014 to February 2015 in Department of Neurology, second Hospital of Lanzhou University. The clinical data of 630 age-matched patients with non-stroke were analyzed and the distribution of carotid plaques in the two groups was analyzed. According to the results of cervical vascular ultrasound, the patients with AIS were divided into four groups: no plaque group (n = 247), stable plaque group (n = 93) and vulnerable plaque group (n = 248). Multivariate logistic regression analysis was performed to identify the independent risk factors for carotid plaque vulnerability. Results the detection rate of carotid plaque in AIS group and control group was 57.99 and 50.955, respectively, and the detectable rate of vulnerable plaque was 42.18 and 33.81 in AIS group. The detectable rate of mass and vulnerable plaque was higher than that of control group. The difference was statistically significant (P 0.05). Age, male ratio, hypertension among different carotid plaque groups, There were significant differences in diabetes mellitus and systolic blood pressure (P 0.05). Multivariate logistic regression analysis showed that age was 1.04395 CI 1.0271.061, male OR1.97395CI 1.37395CI 1.3772.828P0.000, diabetes OR1.45495CI1.004CI1.106P0.047, systolic blood pressure 1.01195CI 1.0021.020P0.016) were independent risk factors of carotid artery vulnerability in AIS patients. Conclusion carotid artery plaque is an independent risk factor for carotid artery plaque in AIS patients with diabetes mellitus (OR1.45495CI1.004CI1.0041.004CI1.004CI1.0021.020P0.016). Vulnerable plaque rupture, Age, sex, diabetes and systolic blood pressure were independent risk factors for carotid plaque vulnerability in patients with AIS.
【作者单位】：兰州大学第二医院神经内科;
【基金】：兰州市科技计划项目(2011-1-134)~~
【分类号】：R743.3

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