Case-control study on association of carotid artery unstable carotid plaque, blood lipid and blood pressure with acute cerebral infarction
-
摘要: 目的 探讨颈动脉不稳定型斑块、血脂、血压与急性脑梗死之间的关系。方法 行彩色多普勒超声检查了解颈动脉斑块性质,同时对比血脂、血压水平,采用病例对照研究设计比较脑梗死组与对照组之间的差异。结果 与对照组比较,脑梗死组斑块检出率高于对照组(χ2=12.477,P<0.001);且不稳定斑块占脑梗死组检出斑块的70.2% ,差异均有统计学意义(χ2=7.754,P=0.005)。脑梗死患者总胆固醇、甘油三酯、极低密度脂蛋白胆固醇及低密度脂蛋白胆固醇高于对照组,高密度脂蛋白胆固醇低于对照组,差异均有统计学意义(均有P<0.05)。两组检出有不稳定斑块者的高密度脂蛋白胆固醇低于无斑块者、低密度脂蛋白胆固醇高于无斑块者,差异均有统计学意义(均有P<0.05)。脑梗死组收缩压及舒张压均高于对照组,差异有统计学意义(均有P<0.05)。研究对象中既往有高血压病史者中,脑梗死组收缩压和舒张压均高于对照组(t1=3.154,P1=0.003;t2=4.384,P2<0.001),差异有统计学意义。结论 急性脑梗死的发病与颈动脉不稳定型斑块、血脂、血压有相关关系,在危险因素出现早期进行积极的干预治疗,对于降低急性脑梗死发病率可能有重要意义。Abstract: Objective To investigate the relationship between carotid artery unstable plaque, blood lipid, blood pressure and the acute cerebral infarction. Methods Color doppler ultrasound was conducted to see the nature of carotid plaque. At the same time, the blood lipid and blood pressure levels of two groups were compared, case-control study design was used to compare the differences between the cerebral infarction group and the control group. Results Compared with the control group, the detection rate of carotid plaque in the cerebral infarction group was higher (χ2=12.477,P<0.001); and unstable plaques occupied 70.2% of the cerebral infarction group detected plaques(χ2=7.754,P=0.005), differences were statistically significant. TC,TG,VLDL and LDL-C of the cerebral infarction group was higher than that of the control group, and HDL-C was lower than that of the control group, differences were statistically significant (all P<0.05). As for the patients detected with unstable plaques, their HDL-C was lower than that of people without plaques and LDL-C was higher than those without plaques, differences were statistically significant(all P<0.05). Systolic blood pressure and diastolic blood pressure of the cerebral infarction group were both higher than that of the control group, differences were statistically significant(all P<0.05). Among the study objects with high blood pressure history, the systolic and diastolic pressure of the cerebral infarction group were higher than that of the control group(t1=3.154,P1=0.003;t2=4.384,P2<0.001) , differences were statistically significant. Conclusions The occurrence of acute cerebral infarct is related to carotid artery unstable carotid plaques, blood lipid and blood pressure. Positive prevention treatment in the early stage of risk factors has potential significance in reducing acute cerebral infarct occurrence rate.
-
Key words:
- Cerebral infarction /
- Dyslipidemia /
- Blood pressure /
- Case control study
-
荆芳华. 高尿酸血症与老年脑梗死相关性的临床分析 [J].中华保健医学杂志,2015,17(2): 101-103. Xie W,Wu Y,Wang W, et al. A longitudinal study of carotid plaque and risk of ischemic cardiovascular disease in the Chinese population [J]. J Am Soc Echocardiogr, 2011,24(7):729-737. 赵焕,操礼琼,石瑜瑜,等. 急性脑梗死与血清炎症因子及颈动脉粥样硬化关系的研究 [J]. 中华疾病控制杂志, 2013,17(6):499-502. Riccioni G. The effect of antihypertensive drugs on carotid intima media thickness: an up-to-date review [J]. Curr Med Chem, 2009,16(8):988-996. Mono ML, Karameshev A, Slotboom J, et al. Plaque characteristics of asymptomatic carotid stenosis and risk of stroke [J]. Cerebrovasc Dis, 2012,34(5-6):343-350. Mauriello A, Sangiorgi G, Virmani R,et al. Evidence of a topographical link between unstable carotid plaques and luminal stenosis: can we better stratify asymptomatic patients with significant plaque burden? [J]. Int J Cardiol, 2012,155(2):309-311. 黄品同,王力,张晓菁,等. 超声对脑梗死患者颈动脉软斑块近心端角度的研究 [J]. 中华超声影像学杂志, 2009,18(12):1040-1042. Staub D, Partovi S, Schinkel AF, et al. Correlation of carotid artery atherosclerotic lesion echogenicity and severity at standard US with intraplaque neovascularization detected at contrast-enhanced US [J]. Radiology, 2011,258(2):618-626. Coli S,Magnoni M,Sangiorgi G, et al. Contrast-enhanced ultrasound imaging of intraplaque neovascularization in carotid arteries: correlation with histology and plaque echogenicity [J]. J Am Coll Cardiol, 2008,52(3):223-230. Koole D, Heyligers J, Moll FL, et al. Intraplaque neovascularization and hemorrhage: markers for cardiovascular risk stratification and therapeutic monitoring [J]. J Cardiovasc Med (Hagerstown), 2012,13(10):635-639. 宋则周,张艳明,傅燕飞,等. 超声造影评估颈动脉斑块增强类型与脑梗死灶体积的关系 [J]. 中华超声影像学杂志, 2014,23(6):539-541. 丁士芳,张运,蒋彦彦. 颈动脉粥样斑块稳定性与急性脑梗死发病机制关系的临床研究 [J]. 中华超声影像学杂志, 2006,15(8):597-600. Chei CL, Yamagishi K, Kitamura A, et al. High-density Lipoprotein Subclasses and Risk of Stroke and its Subtypes in Japanese Population The Circulatory Risk in Communities Study [J]. Stroke, 2013,44(2):327-333. Lei C, Wu B, Liu M, et al. Risk Factors and Clinical Outcomes Associated with Intracranial and Extracranial Atherosclerotic Stenosis Acute Ischemic Stroke [J]. J Stroke Cerebrovasc Dis, 2014,23(5):1112-1117. Lloyd-Jones DM, Evans JC, Larson MG, et al. Cross-classification of JNC VI blood pressure stages and risk groups in the Framingham Heart Study [J]. Arch Intern Med, 1999,159(18):2206-2212. 李效寅,李群策. 血管回声跟踪技术评价脑梗死患者颈总动脉弹性的临床研究 [J]. 中国超声医学杂志, 2010,26(1):48-50.
点击查看大图
计量
- 文章访问数: 299
- HTML全文浏览量: 66
- PDF下载量: 28
- 被引次数: 0