本文選題：動脈粥樣硬化 + 脂蛋白（a）　； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的探討中青年缺血性卒中患者頸動脈粥樣硬化的危險(xiǎn)因素及血清脂蛋白（a）［Lipoprotein(a), Lp(a)］水平對中青年缺血性卒中患者的頸動脈粥樣硬化的影響。 方法收集18～55歲的缺血性卒中患者,采用頸動脈超聲評價(jià)頸動脈粥樣硬化程度，并檢測患者血清總膽固醇、三酰甘油、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、極低密度脂蛋白膽固醇、載脂蛋白A1、載脂蛋白B、Lp(a)濃度。根據(jù)頸動脈超聲結(jié)果分為無動脈粥樣硬化組、有斑塊無狹窄組和頸動脈狹窄組，比較三組的人口統(tǒng)計(jì)學(xué)和臨床特征，并采用多變量logistic回歸分析確定中青年缺血性卒中患者頸動脈粥樣硬化的獨(dú)立危險(xiǎn)因素。 結(jié)果共納入106例缺血性卒中患者。無動脈粥樣硬化組50例，有斑塊無狹窄組44例，頸動脈狹窄組12例，三組間年齡［分別為（45.98±7.12）、（50.07±4.79）和（50.92±1.83）歲；F=7.169，P=0.001］、高血壓（分別為26.0%、47.7%和58.3%；X2=6.862，P=0.032）、糖尿�。ǚ謩e為22.0%、45.5%和66.7%；X2=10.729，P=0.005）、高脂血癥（分別為24.0%、40.1%和75.0%；X2=11.372，P=0.003）和吸煙（分別為34.0%、61.4%和75.%；X2=10.393，P=0.006）患者的構(gòu)成比以及血清高密度脂蛋白膽固醇［分別為（1.03±0.26）、（0.95±0.26）和（0.76±0.08）mmol/L；F=5.882，P=0.004］和Lp(a)［分別為（0.108±0.044）、（0.155±0.028）和（0.200±0.011）g/L；F=41.556，P=0.000］水平存在顯著性差異。多變量logistic回歸分析顯示，年齡48歲[有斑塊無狹窄：優(yōu)勢比（odds ratio,OR）2.89,95%可信區(qū)間（confidence interval,CI）1.20～6.96,P=0.018；頸動脈狹窄：OR4.43，95%CI1.19～16.57,P=0.027]、高血壓（有斑塊無狹窄：OR2.60,95%CI1.09～6.18,P=0.031；頸動脈狹窄：OR3.99，，95%CI1.08～14.77,P=0.039）、糖尿�。ㄓ邪邏K無狹窄：OR2.96,95%CI1.21～7.23,P=0.018；頸動脈狹窄：OR7.09，95%CI1.79～28.02,P=0.005）、高脂血癥（有斑塊無狹窄：OR2.19,95%CI0.91～5.31,P=0.082；頸動脈狹窄：OR9.50，95%CI2.21～40.86,P=0.002）、吸煙（有斑塊無狹窄：OR3.08,95%CI1.33～7.16,P=0.009；頸動脈狹窄：OR5.82，95%CI1.39～24.38,P=0.016）和Lp(a)（有斑塊無狹窄：OR4.38,95%CI1.76～10.90,P=0.001；頸動脈狹窄：OR12.80，95%CI2.73～52.67,P=0.001）為中青年缺血性卒中患者頸動脈粥樣硬化的獨(dú)立危險(xiǎn)因素。結(jié)論年齡、吸煙、高血壓、糖尿病、Lp(a)為中青年缺血性卒中患者頸動脈粥樣硬化的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the risk factors of carotid atherosclerosis in young and middle-aged patients with ischemic stroke and the effect of serum lipoprotein A on carotid atherosclerosis in young and middle-aged patients with ischemic stroke. Methods carotid artery ultrasound was used to evaluate the degree of carotid atherosclerosis in 1855 years old patients with ischemic stroke. Serum total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol were measured. Very low density lipoprotein cholesterol, apolipoprotein A _ 1, apolipoprotein B _ 1, apolipoprotein A) concentration. According to the results of carotid ultrasound, the patients were divided into three groups: no atherosclerotic group, no plaque stenosis group and carotid artery stenosis group. The demographic and clinical characteristics of the three groups were compared. Multivariate logistic regression analysis was used to determine the independent risk factors of carotid atherosclerosis in young and middle-aged patients with ischemic stroke. Results 106 patients with ischemic stroke were included. There were 50 cases in no atherosclerosis group, 44 cases in plaque without stenosis group and 12 cases in carotid artery stenosis group. The age of the three groups was 50.07 鹵4.79 and 50.92 鹵1.83 respectively, hypertension was 26.047.7% and 58.3X26.862P0.032, diabetes (22.045% and 66.7%) respectively. X2=10.729,P=0.005),楂樿剛琛

本文編號：2025139