血脂与高血压脑卒中患者颈动脉狭窄的相关性研究
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摘要
目的探究高血压脑卒中患者血脂水平与颈动脉狭窄程度的相关性。方法方便选取2016年1月—2017年12月98例行高血压合并脑卒中患者为研究对象,所有患者行颈部超声检测,根据患者的颈部动脉狭窄程度分为重度狭窄组(n=41)和轻、中度狭窄组(n=57),比较两组患者血脂水平,采用Spearman相关性分析法分析高血压脑卒中患者血脂与颈动脉狭窄的相关性。结果共98例(58.33%)患者发生颈部动脉狭窄,发生颈动脉狭窄的患者IMT(1.21±0.34)mm和僵硬度(221.39±86.21)]高于未发生颈动脉狭窄患者[(0.53±0.12)mm,(698.15±98.59)],扩张性(0.93±0.16)低于未发生颈动脉狭窄患者(0.27±0.07),差异有统计学意义(P<0.05)。相较于轻度狭窄组与中度狭窄组,重度狭窄组的TC(7.10±1.11)、TG(3.79±0.61)mmol/L和HDL-C(0.97±0.21)mmol/L均处于较高水平,数据比较差异有统计学意义(P<0.05)。相关分析显示,患者颈动脉狭窄程度与患者的血脂水平呈正相关(r=0.669,P=0.027)。结论高血压脑卒中患者血脂水平与颈动脉狭窄程度呈正相关,血脂水平偏高时患者经动脉狭窄的发生风险将升高。
Objective To investigate the relationship between serum lipid levels and carotid stenosis in patients with hypertensive stroke. Methods From January 2016 to December 2017, 98 patients with hypertension and stroke were convenient enrolled. All patients underwent cervical ultrasonography and according to the degree of cervical artery stenosis were divided into severe stenosis(n=41) and the mild and moderate stenosis group(n=57). The blood lipid levels of the two groups were compared. Spearman correlation analysis was used to analyze the correlation between serum lipids and carotid stenosis in patients with hypertensive stroke. Results A total of 98 cases(58.33%) patients had cervical stenosis. IMT(1.21±0.34)mm and stiffness(221.39±86.21) were higher in patients with carotid stenosis than in patients without carotid stenosis [(0.53±0.12)mm, 698.15±98.59)]. The dilatation(0.93±0.16) was lower than that of patients without carotid stenosis(0.27±0.07),and the difference was statistically significant(P<0.05). Compared with the mild stenosis group and the moderate stenosis group, the TC(7.10±1.11), TG(3.79±0.61)mmol/L and HDL-C(0.97±0.21)mmol/L in the severe stenosis group were at a high level, and the data were statistically different. Academic significance(P<0.05). Correlation analysis showed that the degree of carotid stenosis was positively correlated with the patient's blood lipid level(r=0.669, P=0.027). Conclusion The blood lipid level of patients with hypertensive stroke is positively correlated with the degree of carotid stenosis. When the blood lipid level is high, the risk of arterial stenosis will increase.
Objective To investigate the relationship between serum lipid levels and carotid stenosis in patients with hypertensive stroke. Methods From January 2016 to December 2017, 98 patients with hypertension and stroke were convenient enrolled. All patients underwent cervical ultrasonography and according to the degree of cervical artery stenosis were divided into severe stenosis(n=41) and the mild and moderate stenosis group(n=57). The blood lipid levels of the two groups were compared. Spearman correlation analysis was used to analyze the correlation between serum lipids and carotid stenosis in patients with hypertensive stroke. Results A total of 98 cases(58.33%) patients had cervical stenosis. IMT(1.21±0.34)mm and stiffness(221.39±86.21) were higher in patients with carotid stenosis than in patients without carotid stenosis [(0.53±0.12)mm, 698.15±98.59)]. The dilatation(0.93±0.16) was lower than that of patients without carotid stenosis(0.27±0.07),and the difference was statistically significant(P<0.05). Compared with the mild stenosis group and the moderate stenosis group, the TC(7.10±1.11), TG(3.79±0.61)mmol/L and HDL-C(0.97±0.21)mmol/L in the severe stenosis group were at a high level, and the data were statistically different. Academic significance(P<0.05). Correlation analysis showed that the degree of carotid stenosis was positively correlated with the patient's blood lipid level(r=0.669, P=0.027). Conclusion The blood lipid level of patients with hypertensive stroke is positively correlated with the degree of carotid stenosis. When the blood lipid level is high, the risk of arterial stenosis will increase.
引文
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[13]刘瑶,李俊峰,高金全,等.老年H型高血压颈动脉狭窄程度与血脂和炎性因子的相关性研究[J].医学研究杂志,201544(4):146-149.
[14]陶昀璐,华扬,贾凌云,等.血脂水平与缺血性脑血管病患者颈动脉狭窄关系的多中心登记研究[J].中国脑血管病杂志,2017,14(6):292-296.
[15]成晓江,卡合尔曼·卡德尔,张晓杰,等.新疆地区颅外颈动脉狭窄的危险因素分析[J].中国神经精神疾病杂志,2016,42(1):60-64.
[16]陈长春,黎西,孙中武.缺血性脑血管病患者脑动脉狭窄严重程度的影响因素[J].中华疾病控制杂志,2016,20(5)530-532.
[2]Isozaki M,Arai Y,Higashino Y,et al.Cerebral hyperperfusion syndrome resulting in subarachnoid hemorrhage after carotid artery stenting[J].Annals of Nuclear Medicine,2016,30(9):1-6.
[3]李安乐,邵月琴,袁红,等.上海嘉定区高血压患者并发症的发生谱分析[J].中国慢性病预防与控制,2016,24(11):870-872.
[4]Sato S,Delcourt C,Heeley E,et al.Significance of Cerebral Small-Vessel Disease in Acute Intracerebral Hemorrhage[J].Stroke,2016,47(3):701-707.
[5]Sakamoto S,Kiura Y,Okazaki T,et al.Carotid artery stenting for vulnerable plaques on MR angiography and ultrasonogr aphy:utility of dual protection and blood aspiration method.[J].Journal of Neurointerventional Surgery,2016,8(10):1011-1015.
[6]邱笑琼,杨军,陆川,等.结合中医体质因素的缺血性脑血管病脑动脉狭窄危险因素分析[J].中华全科医学,2016,14(2):300-302.
[7]中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南:2016年修订版[J].中国循环杂志,2016,16(10):7-28.
[8]裴亮,刁文丽.辽宁省城乡居民高血压合并血脂异常并发脑出血的高危因素分析[J].现代预防医学,2017,44(6):1039-1043.
[9]刘洁,郑立建,佟小光.分期椎动脉支架置入术和颈动脉内膜剥脱术治疗椎动脉并颈动脉粥样硬化狭窄[J].山东医药,2016,56(43):68-70.
[10]李俊超,何婷婷,胡晓丹,等.高寒地区高血压患者血清25羟维生素D_3水平与颈动脉狭窄程度相关性研究[J].中国骨质疏松杂志,2017,23(9):1207-1211.
[11]秦鹏,沈建平,高昕,等.高血压患者血压控制水平、血脂水平及颈动脉斑块与冠脉病变的关系[J].现代生物医学进展,2017,17(9):1667-1670.
[12]Carcel C,Wang X,Sato S,et al.Degree and Timing of Intensive Blood Pressure Lowering on Hematoma Growth in Intracerebral Hemorrhage:Intensive Blood Pressure Reduc tion in Acute Cerebral Hemorrhage Trial-2 Results[J]Stroke;a journal of cerebral circulation,2016,47(6):1651.
[13]刘瑶,李俊峰,高金全,等.老年H型高血压颈动脉狭窄程度与血脂和炎性因子的相关性研究[J].医学研究杂志,201544(4):146-149.
[14]陶昀璐,华扬,贾凌云,等.血脂水平与缺血性脑血管病患者颈动脉狭窄关系的多中心登记研究[J].中国脑血管病杂志,2017,14(6):292-296.
[15]成晓江,卡合尔曼·卡德尔,张晓杰,等.新疆地区颅外颈动脉狭窄的危险因素分析[J].中国神经精神疾病杂志,2016,42(1):60-64.
[16]陈长春,黎西,孙中武.缺血性脑血管病患者脑动脉狭窄严重程度的影响因素[J].中华疾病控制杂志,2016,20(5)530-532.