常德市汉族居民颈动脉粥样硬化斑块稳定性的相关因素分析

Influencing factors for carotid atherosclerotic plaque stability in Han residents of Changde, China

摘要:

目的 探讨影响常德市汉族居民颈动脉粥样硬化（CAS）斑块稳定性的相关因素。方法 回顾性分析2014年1月至2014年12月期间在常德市第一人民医院门诊部就诊和体检中心进行体检的符合入组标准的对象794例，将入组对象分为稳定斑块组（353例）和不稳定斑块组（441例）。收集一般资料及生化检测结果。根据颈部血管彩色多普勒检查结果，对两组资料进行比较分析。结果 单因素分析显示，两组在高血压、糖尿病、吸烟、年龄、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、纤维蛋白原（FIB）、C-反应蛋白（CRP）和同型半胱氨酸（Hcy）指标上差异有统计学意义（P<0.05）。多因素Logistic回归分析显示，糖尿病（OR=3.115，95%CI：2.163~4.487，P=0.000）、高血压（OR=1.991，95%CI：1.429~2.772，P=0.000）、吸烟（OR=1.372，95%CI：1.001~1.879，P=0.049）、LDL-C（OR=1.308，95%CI：1.084~1.578，P=0.005）、FIB（OR=1.291，95%CI：1.055~1.580，P=0.013）、TC（OR=1.216，95%CI：1.001~1.477，P=0.049）、年龄（OR=1.033，95%CI：1.017~1.048，P=0.000）和Hcy（OR=1.031，95%CI：1.009~1.053，P=0.006）是CAS不稳定斑块形成的危险因素，差异具有统计学意义（P<0.05）。HDL-C（OR=0.447，95%CI：0.270~0.740，P=0.002）是CAS不稳定斑块形成的保护因素，差异具有统计学意义（P<0.05）。结论 糖尿病、高血压、吸烟、LDL-C、FIB、TC、Hcy和年龄是常德市汉族居民CAS不稳定斑块的危险因素，HDL-C是常德市汉族居民CAS斑块稳定性的保护因素。

Abstract:

Objective To investigate the influencing factors for carotid atherosclerotic plaque stability in Han residents in Changde, China.Methods A retrospective analysis was performed for the clinical data of 794 subjects who visited the outpatient service or underwent physical examination in Physical Examination Center in The First People's Hospital of Changde from January to December, 2014. These subjects were divided into stable plaque group (353 patients) and unstable plaque group (441 patients). General information and results of biochemical examination were collected. The two groups were compared based on the results of color Doppler examination of cervical vessels.Results The univariate analysis showed that there were significant differences between the two groups in hypertension, diabetes, smoking, age, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fibrinogen (FIB), C-reactive protein (CRP), and homocysteine (Hcy) (P<0.05). The multivariate logistic regression analysis revealed that diabetes (odds ratio [OR]=3.115, 95% confidence interval [CI] 2.163-4.487, P=0.000), hypertension (OR=1.991, 95% CI 1.429-2.772, P=0.000), smoking (OR=1.372, 95% CI 1.001-1.879, P=0.049), LDL-C (OR=1.308, 95% CI 1.084-1.578, P=0.005), FIB (OR=1.291, 95% CI 1.055-1.580, P=0.013), TC (OR=1.216, 95% CI 1.001-1.477, P=0.049), age (OR=1.033, 95% CI 1.017-1.048, P=0.000), and Hcy (OR=1.031, 95%CI 1.009-1.053, P=0.006) were risk factors for the formation of unstable plaque in carotid atherosclerosis (CAS) (P<0.05), while HDL-C (OR=0.447, 95%CI 0.270-0.740, P=0.002) was the protective factor (P<0.05).Conclusions In Han residents in Changde, diabetes, hypertension, smoking, LDL-C, FIB, TC, Hcy, and age are risk factors for unstable plaque in CAS, while HDL-C is a protective factor.