血清脂蛋白（a）水平与中青年缺血性卒中患者的颈动脉粥样硬化的相关性：回顾性病例系列研究

发布时间：2018-06-16 03:44

  本文选题：动脉粥样硬化 + 脂蛋白（a）　； 参考：《安徽医科大学》2014年硕士论文

【摘要】：目的探讨中青年缺血性卒中患者颈动脉粥样硬化的危险因素及血清脂蛋白（a）［Lipoprotein(a), Lp(a)］水平对中青年缺血性卒中患者的颈动脉粥样硬化的影响。 方法收集18～55岁的缺血性卒中患者,采用颈动脉超声评价颈动脉粥样硬化程度，并检测患者血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、极低密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B、Lp(a)浓度。根据颈动脉超声结果分为无动脉粥样硬化组、有斑块无狭窄组和颈动脉狭窄组，比较三组的人口统计学和临床特征，并采用多变量logistic回归分析确定中青年缺血性卒中患者颈动脉粥样硬化的独立危险因素。 结果共纳入106例缺血性卒中患者。无动脉粥样硬化组50例，有斑块无狭窄组44例，颈动脉狭窄组12例，三组间年龄［分别为（45.98±7.12）、（50.07±4.79）和（50.92±1.83）岁；F=7.169，P=0.001］、高血压（分别为26.0%、47.7%和58.3%；X2=6.862，P=0.032）、糖尿病（分别为22.0%、45.5%和66.7%；X2=10.729，P=0.005）、高脂血症（分别为24.0%、40.1%和75.0%；X2=11.372，P=0.003）和吸烟（分别为34.0%、61.4%和75.%；X2=10.393，P=0.006）患者的构成比以及血清高密度脂蛋白胆固醇［分别为（1.03±0.26）、（0.95±0.26）和（0.76±0.08）mmol/L；F=5.882，P=0.004］和Lp(a)［分别为（0.108±0.044）、（0.155±0.028）和（0.200±0.011）g/L；F=41.556，P=0.000］水平存在显著性差异。多变量logistic回归分析显示，年龄48岁[有斑块无狭窄：优势比（odds ratio,OR）2.89,95%可信区间（confidence interval,CI）1.20～6.96,P=0.018；颈动脉狭窄：OR4.43，95%CI1.19～16.57,P=0.027]、高血压（有斑块无狭窄：OR2.60,95%CI1.09～6.18,P=0.031；颈动脉狭窄：OR3.99，，95%CI1.08～14.77,P=0.039）、糖尿病（有斑块无狭窄：OR2.96,95%CI1.21～7.23,P=0.018；颈动脉狭窄：OR7.09，95%CI1.79～28.02,P=0.005）、高脂血症（有斑块无狭窄：OR2.19,95%CI0.91～5.31,P=0.082；颈动脉狭窄：OR9.50，95%CI2.21～40.86,P=0.002）、吸烟（有斑块无狭窄：OR3.08,95%CI1.33～7.16,P=0.009；颈动脉狭窄：OR5.82，95%CI1.39～24.38,P=0.016）和Lp(a)（有斑块无狭窄：OR4.38,95%CI1.76～10.90,P=0.001；颈动脉狭窄：OR12.80，95%CI2.73～52.67,P=0.001）为中青年缺血性卒中患者颈动脉粥样硬化的独立危险因素。结论年龄、吸烟、高血压、糖尿病、Lp(a)为中青年缺血性卒中患者颈动脉粥样硬化的独立危险因素。
[Abstract]:Objective to investigate the risk factors of carotid atherosclerosis in young and middle-aged patients with ischemic stroke and the effect of serum lipoprotein A on carotid atherosclerosis in young and middle-aged patients with ischemic stroke. Methods carotid artery ultrasound was used to evaluate the degree of carotid atherosclerosis in 1855 years old patients with ischemic stroke. Serum total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol were measured. Very low density lipoprotein cholesterol, apolipoprotein A _ 1, apolipoprotein B _ 1, apolipoprotein A) concentration. According to the results of carotid ultrasound, the patients were divided into three groups: no atherosclerotic group, no plaque stenosis group and carotid artery stenosis group. The demographic and clinical characteristics of the three groups were compared. Multivariate logistic regression analysis was used to determine the independent risk factors of carotid atherosclerosis in young and middle-aged patients with ischemic stroke. Results 106 patients with ischemic stroke were included. There were 50 cases in no atherosclerosis group, 44 cases in plaque without stenosis group and 12 cases in carotid artery stenosis group. The age of the three groups was 50.07 卤4.79 and 50.92 卤1.83 respectively, hypertension was 26.047.7% and 58.3X26.862P0.032, diabetes (22.045% and 66.7%) respectively. X2=10.729,P=0.005),楂樿剛琛

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