颈动脉超声应用筛查颈动脉狭窄及脑卒中高危因素分析

Role of carotid artery sonography in screening for high-risk factors of carotid stenosis and stroke

摘要:

目的 分析广西壮族自治区梧州市角嘴社区颈动脉超声应用筛查颈动脉狭窄结果及脑卒中的高危因素。方法 选择2013年1月~2015年3月广西壮族自治区梧州市角嘴社区5789名居民为研究对象，对其采用问卷调查及体格检查，统计分析颈动脉超声检查的结果及脑卒中高危因素。结果 调查的5789名居民中，≥60岁居民内膜增厚发生率26.65%，斑块形成率为13.67%；40~60岁居民内膜增厚发生率9.20%，斑块形成率为4.42%。≥60岁居民的内膜增厚发生率和斑块发生率均比40~60岁居民高（P<0.05）。男性内膜增厚发生率27.89%，斑块形成率为11.38%，女性内膜增厚发生率8.06%，斑块形成率为7.37%。男性内膜增厚发生率和斑块发生率均比女性居民高（P<0.05）。居民的脑卒中高危因素分析表明，吸烟史、高血压病、明显超重或肥胖、缺乏运动所占比例高，分别为14.32%、16.02%、16.02%、35.13%，与其他因素相比差异具有统计学意义（P<0.05）；高血压病、明显超重或肥胖、缺乏运动与脑卒中的发生关联较大（P<0.05）。结论 广西壮族自治区梧州市角嘴社区脑卒中高危人群的干预的重点方向应为降低血压、控制饮食和多运动。通过开展颈动脉血管超声检查，实现居民脑卒中前期患者的早发现、早干预、早治疗。

Abstract:

Objective To investigate the role of carotid artery sonography in the screening for high-risk factors of carotid stenosis and stroke in Jiaozui Community of Wuzhou in Guangxi Zhuang Autonomous Region, China.Methods The questionnaire investigation and physical examination were performed for 5789 residents in Jiaozui Community of Wuzhou in Guangxi Zhuang Autonomous Region from January 2013 to March 2015. The results of carotid artery sonography and high-risk factors of stroke were analyzed.Results In these 5789 residents, the residents aged ≥60 years had significantly higher incidence rate of intimal thickening and rate of plaque formation than those aged 40-60 years (incidence rate of intimal thickening: 26.65% vs. 9.20%, P<0.05; rate of plaque formation: 13.67% vs. 4.42%, P<0.05). The male residents had significantly higher incidence rate of intimal thickening and rate of plaque formation than female residents (incidence rate of intimal thickening: 27.89% vs. 8.06%, P<0.05; rate of plaque formation: 11.38% vs. 7.37%, P<0.05). The analysis of the high-risk factors of stroke showed that smoking history, hypertension, marked overweight/obesity, and lack of exercise accounted for 14.32%, 16.02%, 16.02%, and 35.13%, respectively, and there were significant differences between these factors and other factors (P<0.05). Hypertension, marked overweight/obesity, lack of exercise were greatly associated with stroke (P<0.05).Conclusions The important interventions for high-risk population in Jiaozui Community of Wuzhou in Guangxi Zhuang Autonomous Region should focus on reduction of blood pressure, diet control, and more exercise. Carotid artery sonography helps with the early discovery, intervention, and treatment of patients with early-stage stroke.