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目的探讨影响颈动脉粥样硬化斑块对称性分布的危险因素。方法前瞻性入组81例缺血性卒中患者作为研究对象,均进行了颈动脉多对比序列、黑血、高分辨磁共振成像(magnetic resonance imaging,MRI)。根据MRI结果将患者分为颈动脉无易损斑块组(40例)、单侧易损斑块组(26例)和双侧易损斑块组(15例)。记录患者年龄、性别、高血压、糖尿病、目前吸烟史、血压值、脉压、体质指数(body mass index,BMI)和血脂水平等临床资料。采用Logistic回归分析颈动脉易损斑块形成的危险因素。结果单因素分析显示,无易损斑块组、单侧易损斑块组和双侧易损斑块组患者在高血压病史、目前吸烟史、体质指数、收缩压等方面差异具有显著性。多因素Logistic回归分析显示,目前吸烟史是易损斑块对称性分布的独立影响因素[比值比(odds ratio,OR)3.136,95%可信区间(confidence interval,CI)1.122~8.766,P=0.03]。结论目前吸烟史与颈动脉易损斑块的对称性分布有相关性。
Objective To explore the risk factors influencing the symmetry distribution of carotid atherosclerotic plaques. Methods A total of 81 patients with ischemic stroke were prospectively enrolled. All subjects underwent carotid multi-contrast, black blood and high-resolution magnetic resonance imaging (MRI). The patients were divided into carotid non-vulnerable plaque group (40 cases), unilateral vulnerable plaque group (26 cases) and bilateral vulnerable plaque group (15 cases) according to MRI results. Age, gender, hypertension, diabetes mellitus, current smoking history, blood pressure, pulse pressure, body mass index (BMI) and serum lipid levels were recorded. Logistic regression was used to analyze the risk factors of carotid vulnerable plaque formation. Results Univariate analysis showed that there were significant differences in the history of hypertension, current smoking history, body mass index and systolic blood pressure in the group of non-vulnerable plaque, unilateral vulnerable plaque and bilateral vulnerable plaque. Multivariate Logistic regression analysis showed that the current smoking history was an independent factor affecting the distribution of symmetry of vulnerable plaques (odds ratio (OR) 3.136, 95% confidence interval (CI) 1.122-8.766, P = 0.03]. Conclusion There is a correlation between smoking history and the symmetry distribution of carotid vulnerable plaque.