颈动脉狭窄病人继发脑缺血事件的相关因素分析

发布时间：2018-05-15 15:25

本文选题：颈动脉狭窄 + 脑缺血事件　；参考：《浙江大学》2017年硕士论文

【摘要】：目的探讨颈动脉狭窄病人继发脑缺血事件的危险因素。方法回顾性分析2013年1月至2016年9月浙医二院神经外科收治的169例手术治疗的颈动脉狭窄病人,其中符合脑缺血事件组(实验组)纳入标准的有84例,符合无脑缺血事件组(对照组)纳入标准的有28例。通过单因素及多因素Logistic回归分析方法,分析年龄、性别、BMI、高血压病史、糖尿病病史、高脂血症病史、冠心病病史、抽烟史、饮酒史、血糖水平、胆固醇水平、甘油三酯水平、HDL水平、LDL水平、颈动脉狭窄程度、斑块内新生血管级别、斑块内出血、左心室肥厚与脑缺血事件的关系。结果实验组的新生血管级别要显著高于对照组(p=0.030),实验组狭窄程度在重度及以上的病人比例虽然高于对照组(78.57%vs60.71%),但其并不存在显著差异(p=0.289),而其他因素如年龄,性别,BMI,既往高血压、糖尿病、冠心病、高脂血症、抽烟史、饮酒史等病史,斑块内出血,左心室肥厚,胆固醇,甘油三酯,HDL,LDL均与脑缺血事件无显著相关性(p0.05)。多因素分析结果证明斑块内新生血管级别是继发脑缺血事件的独立危险因素(p=0.011,95%CI=1.313-7.957)。结论颈动脉狭窄病人的斑块内新生血管级别与脑缺血事件发生史密切相关,而其他因素如年龄、性别、抽烟史、血糖水平、胆固醇水平、甘油三酯水平、LDL水平等则与脑缺血事件的发生无明显联系。
[Abstract]:Objective to investigate the risk factors of secondary cerebral ischemia in patients with carotid artery stenosis. Methods from January 2013 to September 2016, 169 patients with carotid artery stenosis treated in neurosurgery department of Zhejiang Medical second Hospital were retrospectively analyzed. Among them, 84 cases met the criteria of cerebral ischemia event group (experimental group). There were 28 patients who met the inclusion criteria in the control group (control group). Age, sex, hypertension, diabetes, hyperlipidemia, coronary heart disease, smoking, alcohol consumption, blood glucose level and cholesterol level were analyzed by univariate and multivariate Logistic regression analysis. Triglyceride level HDL level LDL level, carotid artery stenosis, intraplaque neovascularization, plaque hemorrhage, left ventricular hypertrophy and cerebral ischemia events. Results the grade of neovascularization in the experimental group was significantly higher than that in the control group (P 0.030). Although the proportion of patients with severe stenosis in the experimental group was higher than that in the control group (78.57 vs 60.71), there was no significant difference in the grade of neovascularization between the two groups. Diabetes, coronary heart disease, hyperlipidemia, smoking history, drinking history, plaque hemorrhage, left ventricular hypertrophy, cholesterol, triglyceride HDL- LDL were not significantly correlated with cerebral ischemia events (P 0.05). Multivariate analysis showed that intraplaque neovascularization was an independent risk factor for secondary cerebral ischemia events. Conclusion Intra-plaque neovascularization in patients with carotid artery stenosis is closely related to the history of cerebral ischemia events, while other factors such as age, sex, smoking history, blood glucose level, cholesterol level, etc. Triglyceride levels and LDL levels were not significantly associated with cerebral ischemic events.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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