脑卒中高危人群颈动脉超声筛查阳性率现况及其影响因素

doi:10.12183/j.scjpm.2026.0678

摘要/Abstract

摘要： 目的调查脑卒中高危人群颈动脉超声筛查阳性率及其影响因素。方法 2025年1—12月,选取社区卫生服务中心、基层卫生服务机构及医院体检中心的脑卒中高危人群,行颈动脉超声检查,收集人口学、生活方式及病史资料,采用多因素logistic回归模型分析筛查阳性的影响因素。结果纳入脑卒中高危人群1 259例,超声阳性668例（52.47%）,其中颈动脉内中膜厚度（IMT）增厚480例（38.13%）、斑块412例（32.72%）、颈动脉狭窄96例（7.62%）;412例斑块中软斑152例、硬斑177例、混合斑83例。多因素logistic回归分析结果显示,年龄（40~<60岁OR=3.320;≥60岁OR=4.793）、吸烟（既往OR=1.498;当前OR=2.641）、饮酒（≤15 g/d OR=1.845;>15 g/d OR=1.913）、体力活动（不足OR=1.536）、钠盐（OR=1.801）、高血压（OR=1.550）、糖尿病（OR=1.406）、高血脂（OR=1.977）、卒中史（OR=1.690）、BMI（OR=1.095）、HbA1c（OR=1.648）、LDL-C（OR=2.411）、Hcy（OR=1.181）均为阳性结果的影响因素（均P<0.05）。结论脑卒中高危人群颈动脉超声阳性检出率高;增龄、吸烟、饮酒、体力活动不足、高盐饮食、高血压、糖尿病、血脂异常、卒中史、高BMI、高HbA1c、高LDL-C、高Hcy是阳性的危险因素。

关键词: 脑卒中高危人群, 颈动脉超声, 颈动脉内中膜厚度, 斑块, 颈动脉狭窄, 影响因素

Abstract: Objective To investigate the positive rate of carotid artery ultrasound screening and its associated influencing factors among a high-risk population for stroke. Methods Between January and December 2025, a cohort of individuals at high risk for stroke was recruited from community health service centers, primary healthcare facilities, and hospital physical examination centers. All participants underwent carotid artery ultrasound. Data pertaining to demographics, lifestyle, and medical history were systematically collected. A multivariate logistic regression analysis was employed to identify the determinants of positive ultrasound screening results. Results A total of 1 259 participants were enrolled, of whom 668 (52.47%) exhibited positive ultrasound findings. Among these, increased intima-media thickness (IMT) was observed in 480 cases (38.13%), carotid plaque was detected in 412 cases (32.72%), and carotid artery stenosis was identified in 96 cases (7.62%). Of the 412 cases with plaque, 152 were categorized as soft plaques, 177 as hard plaques, and 83 as mixed plaques. The multivariate logistic regression analysis revealed that age (40 to <60 years, OR=3.320; ≥60 years, OR=4.793), smoking history (former smoker, OR=1.498; current smoker, OR=2.641), alcohol consumption (≤15 g/day, OR=1.845; >15 g/day, OR=1.913), insufficient physical activity (OR=1.536), high sodium intake (OR=1.801), hypertension (OR=1.550), diabetes mellitus (OR=1.406), dyslipidemia (OR=1.977), a history of stroke (OR=1.690), Body Mass Index (BMI) (OR=1.095), Hemoglobin A1c (HbA1c) (OR=1.648), Low-Density Lipoprotein Cholesterol (LDL-C) (OR=2.411), and Homocysteine (Hcy) (OR=1.181) were all significant positive influencing factors (all P<0.05). Conclusion The detection rate of positive findings via carotid artery ultrasound is substantial within the high-risk population for stroke. Advanced age, smoking, alcohol consumption, inadequate physical activity, a high-salt diet, hypertension, diabetes, dyslipidemia, a prior history of stroke, elevated BMI, and increased levels of HbA1c, LDL-C, and Hcy are identified as significant risk factors for positive carotid ultrasound findings.

Key words: High-risk stroke population, Carotid artery ultrasound, Carotid intima-media thickness, Plaque, Carotid stenosis, Influencing factors

中图分类号:

R181.2

彭矜语, 裴峰, 胡滨. 脑卒中高危人群颈动脉超声筛查阳性率现况及其影响因素[J]. 华南预防医学, 2026, 52(6): 678-683.

Peng Jinyu, Pei Feng, Hu Bin. Prevalence and associated factors of positive findings on carotid artery ultrasound screening in a high-risk stroke population[J]. South China Journal of Preventive Medicine, 2026, 52(6): 678-683.

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