基于二级预防分析缺血性脑血管病患者颈动脉斑块形成及稳定性的影响因素

doi:10.12183/j.scjpm.2023.1136

摘要/Abstract

摘要： 目的基于二级预防分析缺血性脑血管病患者颈动脉斑块形成及稳定性的影响因素。方法以2019年1月至2022年12月北京某医院收治且已录入医院病历管理系统中诊断为缺血性脑血管病患者作为研究对象,对患者开展问卷调查、颈动脉彩色超声检查,采用描述性分析方法对研究对象的颈动脉斑块形成情况及稳定性进行分析,并采用单、多因素分析方法对颈动脉斑块形成情况及稳定性影响因素进行分析。结果 2 050例缺血性脑血管病患者分为有斑块形成患者359例,无斑块形成1 691例。359例有斑块形成的患者经斑块稳定性检查发现块斑块稳定性有162例,斑块不稳定性有197例。多因素logistic回归分析结果显示,年龄≥80岁（OR=4.495）、合并高血压（OR=2.199）、合并高同型半胱氨酸血症（OR=3.235）和颅内外动脉狭窄（OR=2.807）是缺血性脑血管病患者颈动脉斑块形成的危险因素,遵从医嘱使用抗血小板药（OR=0.276）和合理膳食（OR=0.358）是降低缺血性脑血管疾病颈动脉斑块形成的保护因素。年龄≥80岁（OR=2.804）和合并高同型半胱氨酸血症（OR=2.707）是缺血性脑血管病患者颈动脉斑块稳定性的危险因素,遵从医嘱使用抗血小板药（OR=0.366）是缺血性脑血管疾病颈动脉斑块稳定性的保护因素。结论基于二级预防分析发现高龄、颅内外动脉狭窄是影响缺血性脑血管病患者颈动脉斑块形成和斑块稳定性的危险因素,遵从医嘱使用抗血小板药是保护因素。

关键词: 缺血性脑血管病, 颈动脉斑块形成, 斑块稳定性, 影响因素, 二级预防

Abstract: Objective To analyze the influencing factors of carotid plaque formation and stability in patients with ischemic cerebrovascular disease based on secondary prevention. Methods A questionnaire survey and carotid artery color ultrasound examination were conducted on patients diagnosed with ischemic cerebrovascular disease who were admitted to a hospital in Beijing from January 2019 to December 2022 and had been recorded in the hospital medical record management system. The descriptive analysis method was used to analyze the formation and stability of the carotid plaque in the patients, and univariate and multivariate analysis methods were used to analyze the factors influencing carotid plaque formation and stability. Results A total of 2 050 patients with ischemic cerebrovascular disease were divided into 359 patients with plaque formation and 1 691 patients without plaque formation. Among the 359 patients with plaque formation, the plaque stability test showed that 162 patients had stable plaques and 197 patients had unstable plaques. The results of multivariate logistic regression analysis showed that age≥80 years old （OR=4.495）, concomitant hypertension （OR=2.199）, concomitant hyperhomo‐cysteinemia （OR=3.235）, and intracranial and extracranial artery stenosis （OR=2.807） were risk factors for the formation of carotid plaques in patients with ischemic cerebrovascular disease; Following medical advice to use antiplatelet drugs （OR=0.276） and a reasonable diet （OR=0.358） were protective factors in reducing the formation of carotid plaques in ischemic cerebrovascular disease. Age≥80 years old （OR=2.804） and concomitant hyperhomo‐cysteinemia （OR=2.707） were risk factors for the stability of carotid plaques in patients with ischemic cerebrovascular disease; Following medical advice to use antiplatelet drugs （OR=0.366） was a protective factor for the stability of carotid plaques in ischemic cerebrovascular disease. Conclusion Based on the secondary prevention analysis, it is found that the elderly and intracranial and extracranial artery stenosis are the risk factors affecting the formation and stability of carotid plaque in patients with ischemic cerebrovascular disease, and following medical advice to use antiplatelet drugs is a protective factor.

Key words: Ischemic cerebrovascular disease, Carotid plaque formation, Plaque stability, Influencing factor, Secondary prevention

中图分类号:

R743

赵学伟, 熊璐璐, 李海燕, 王莉莉. 基于二级预防分析缺血性脑血管病患者颈动脉斑块形成及稳定性的影响因素[J]. 华南预防医学, 2023, 49(9): 1136-1140.

ZHAO Xuewei, XIONG Lulu, LI Haiyan, WANG Lili. Factors affecting carotid plaque formation and stability in patients with ischemic cerebrovascular disease： an analysis based on secondary prevention[J]. South China Journal of Preventive Medicine, 2023, 49(9): 1136-1140.

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