颈动脉粥样硬化斑块形成相关危险因素临床探讨.docVIP

颈动脉粥样硬化斑块形成的相关危险因素的临床探讨 　　作者：金远志,王邦宁　　作者单位：合肥 安徽医科大学第一附属医院心内科一病区 　　【摘要】目的探讨颈动脉粥样硬化斑块形成的相关危险因素,为临床上及早诊治冠状动脉粥样硬化及脑梗死等常见心脑血管疾病提供依据。方法 选择2008年6月至2009年12月期间经颈动脉超声检查的患者175例，根据检查结果将患者分为斑块组(97例)和无斑块组(78例)两组，记录所有患者血脂情况，包括：三酰甘油三酯( TG) 、总胆固醇(TC) 、低密度脂蛋白(LDL-C) 、极低密度脂蛋白(VLDL)、高密度脂蛋白(HDL-C)、载脂蛋白A(apoA)、载脂蛋白B(apoB)、脂蛋白(a)[Lp(a)]，空腹血糖水平(FBG)，纤维蛋白原(FIB)浓度，同时了解患者既往是否有高血压、糖尿病、吸烟饮酒史等病史，进行统计学分析。结果 斑块组高血压发病率、TC、TG、LDL-C、apoB、Lp(a)、FIB浓度、糖代谢异常发病率显著高于无斑块组(P均0.05)，两组间吸烟饮酒史、载脂蛋白A(apoA)、极低密度脂蛋白(VLDL)和高密度脂蛋白(HDL)水平比较差异无统计学意义，Logistic多元回归分析显示，低密度脂蛋白、高血压、糖代谢异常、脂蛋白(a)、纤维蛋白原浓度与颈动脉粥样硬化呈显著正相关。结论 颈动脉斑块形成是多种危险因素共同作用的结果，其中低密度脂蛋白、高血压、糖代谢异常、脂蛋白(a)、纤维蛋白原浓度是颈动脉斑块形成的独立危险因素，三酰甘油、总胆固醇增高是颈动脉斑块形成的相关因素。 　　【关键词】 颈动脉,动脉粥样硬化伴斑块形成,血脂,纤维蛋白原 　　[Abstract]Objective To investigate the risk factors related to the formation of the carotid atherosclerotic plaque so as to prevent and treat the cardiovascular or cerebrovascular diseases evidentially as early as possible.Methods Clinical data of 175 in-patients who underwent color Doppler uhrasonography of cervical artery in our hospital between June 2008 and December 2009 were analyzed.They were all examined with the carotid colour Doppler flow imaging, and were grouped as plaque group (n= 97) and non plaque group (n= 78) according to the results of duplex color Doppler flow imaging，Patients of the two groups were compared statistically in the level of some possible risk factors including ：smoking,drinking, hypertension, glycometabolism abnormality, blood glucose (BG) , fibrinogen(FIB)， blood cholesterin(CHOL) and triglyceride (TC) , Lipoprotein(a)(LP(a))，apolipo-poteint A(apoA)，apolipo-poteint B(apoB)，high density lipoprotein (HDL)，very low density lipoprotein(VLDL) and low density lipoprotein(LDL)。 Logistic regression model was applied in the screening of risk factors.Results The mean total cholesterol, mean triglyceride, mean low density lipoprotein，mean apolipo-poteint B，mean fibrinogen，incidences of hypertension and abnormal glycometabolism were significantl