【摘要】：目的:應(yīng)用彩色多普勒對頸動脈斑塊進(jìn)行篩查,探討頸動脈斑塊形成的危險因素及影響斑塊穩(wěn)定性的因素。方法:150例受檢者行頸動脈彩色多普勒超聲超聲檢查,檢測出頸動脈粥樣硬化斑塊92例,應(yīng)用Logistic回歸分析篩選出差異有統(tǒng)計學(xué)意義的各變量及各變量發(fā)生頸動脈粥樣硬化斑塊的優(yōu)勢比(OR),評價各變量對頸動脈粥樣硬化斑塊形成的危險性。根據(jù)斑塊的超聲特點進(jìn)一步分為穩(wěn)定性斑塊及不穩(wěn)定性斑塊,進(jìn)行多因素Logistic回歸分析,得出具有統(tǒng)計學(xué)意義的指標(biāo)。結(jié)果:通過頸動脈斑塊形成的單因素回歸分析得出,年齡、高血壓史、糖尿病史、甘油三脂(TG)、低密度脂蛋白(LDL)、C反應(yīng)蛋白(CRP)等與頸動脈斑塊的形成密切相關(guān),進(jìn)一步做多因素Logistic回歸,得出年齡、高血壓史、糖尿病史是頸動脈斑塊形成的獨立危險因素(P0.05),其中OR值從大到小依次為糖尿病史(OR值為4.842)、年齡(OR值為0.946)及高血壓史(OR值為0.542)。糖尿病史的OR值最高,說明有糖尿病史者得頸動脈斑塊的風(fēng)險最高。通過對頸動脈斑塊穩(wěn)定性的多因素回歸分析得出,CRP是影響斑塊穩(wěn)定性的危險因素,同時通過Spearsman相關(guān)分析進(jìn)一步得出CRP與頸動脈斑塊的穩(wěn)定性呈正相關(guān)(相關(guān)系數(shù)為0.734,P:0.000),即CRP越高,斑塊越不穩(wěn)定。結(jié)論:頸動脈彩色多普勒超聲因其無創(chuàng)性、經(jīng)濟、便捷、易于重復(fù)等優(yōu)點,可作為反映動脈粥樣硬化程度的一個“窗口”。通過對頸動脈斑塊進(jìn)行篩查,并分析斑塊的穩(wěn)定性,指導(dǎo)我們結(jié)合臨床及各項實驗室指標(biāo)探討引起頸動脈斑塊的危險因素,從而間接評估心血管疾病發(fā)生的潛在風(fēng)險,減少心血管意外的發(fā)生。
[Abstract]:Objective: to investigate the risk factors of carotid plaque formation and the factors affecting plaque stability by color Doppler imaging (CDFI). Methods: one hundred and fifty cases of carotid artery atherosclerotic plaques were examined by color Doppler ultrasonography, 92 cases of carotid atherosclerotic plaques were detected. The risk of carotid atherosclerotic plaque formation was evaluated by Logistic regression analysis among the variables and the predominance of each variable in carotid atherosclerotic plaques compared with (OR), in evaluating the risk of carotid atherosclerotic plaque formation. According to the ultrasonic characteristics of plaques, the stable plaques and unstable plaques were further divided into stable plaques and unstable plaques. The multivariate Logistic regression analysis was carried out, and a statistically significant index was obtained. Results: univariate regression analysis showed that age, history of hypertension, history of diabetes, triglyceride (TG), low density lipoprotein (LDL), C reactive protein (CRP) were closely related to carotid plaque formation. Further multivariate Logistic regression showed that age hypertension history and diabetes history were independent risk factors for carotid plaque formation (P0.05) in which the OR values were diabetes history (OR = 4.842) age (OR = 0.946) and hypertension history (OR = 0.542). OR was the highest in diabetes history, suggesting that people with diabetes had the highest risk of carotid plaque. By multivariate regression analysis of carotid plaque stability, CRP was found to be a risk factor for plaque stability. At the same time, by Spearsman correlation analysis, a positive correlation between CRP and carotid plaque stability was obtained (correlation coefficient was 0.734p: 0.000), that is, the higher the CRP was, the higher the plaque stability was. The more unstable the plaque. Conclusion: carotid color Doppler ultrasound can be used as a window to reflect the degree of atherosclerosis because of its advantages of noninvasive, economical, convenient and easy to repeat. By screening carotid plaques and analyzing the stability of carotid plaques, we can explore the risk factors of carotid plaques in combination with clinical and laboratory indicators, so as to indirectly assess the potential risk of cardiovascular disease. Reduce cardiovascular accidents.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.1;R743.3

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