Risk Factors Analysis for Symmetrical Distribution of Carotid Atherosclerotic Vulnerable Plaque

doi:10.3969/j.issn.1673-5765.2017.07.009

Abstract

Abstract:

Objective To investigate the risk factors affecting the symmetrical distribution of carotid atherosclerotic plaques. Methods A total of 81 patients with ischemic stroke patients were prospectively enrolled consecutively as the research subject, whom were performed with more comparative sequence, black blood and carotid artery high resolution magnetic resonance imaging (MRI). According to the results of MRI, the patients were divided into 3 groups with no high risk vulnerable plaque group (n =40), unilateral high risk vulnerable plaque group (n =26) and bilateral high risk vulnerable plaque group (n =15). The clinical data of age, sex, hypertension, diabetes, current smoking history, blood pressure value, pulse pressure, BMI index and blood lipid level etc. were recorded. Logistic regression analysis was used to analyze the risk factors for carotid artery vulnerable plaque formation. Results Single factor analysis showed that there were statistically significant differences in hypertension history, current smoking history, BMI and systolic pressure in three groups (P <0.05). Multi-factors Logistic regression analysis showed that current smoking history (OR 3.136, 95%CI 1.122-8.766, P =0.03) was an independent factor for the occurrence of high risk vulnerable plaque and its symmetrical distribution. Conclusion There is correlation between current smoking history and the symmetrical distribution of carotid plaque. Smoking cessation might be good for the stability of plaque.

Key words: Carotid artery; Vulnerable plaque; Symmetrical distribution; Risk factors

摘要：

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。

关键词: 颈动脉; 易损斑块; 对称性分布; 危险因素

MI Dong-Hua, ZHAO Xi-Hai, GONG Xi-Ping, et al.. Risk Factors Analysis for Symmetrical Distribution of Carotid Atherosclerotic Vulnerable Plaque[J]. Chinese Journal of Stroke, 2017, 12(07): 609-613.

米东华，赵锡海，龚浠平，董可辉，赵性泉，王春雪，王伊龙，王拥军，刘丽萍. 影响颈动脉粥样硬化易损斑块对称性分布的危险因素分析[J]. 中国卒中杂志, 2017, 12(07): 609-613.

References

1 Chaturvedi S，Bruno A，Feasby T，et al. Carotid

endarterectomy--an evidence-based review：Report

of the therapeutics and technology assessment

subcommittee of the american academy of

neurology[J]. Neurology，2005，65(6)：794-801.

2 Fairhead JF，Mehta Z，Rothwell PM. Populationbased

study of delays in carotid imaging and surgery

and the risk of recurrent stroke[J]. Neurology，2005，

65(3)：371-375.

3 Wasserman BA，Sharrett AR，Lai S，et al. Risk

factor associations with the presence of a lipid core

in carotid plaque of asymptomatic individuals using

high-resolution mri：The multi-ethnic study of

atherosclerosis (mesa)[J]. Stroke，2008，39(2)：329-

335.

4 Zhang Y，Bai L，Shi M，et al. Features and risk

factors of carotid atherosclerosis in a population with

high stroke incidence in China[J]. Oncotarget，2017，

doi：10. 18632/oncotarget. 15415.

5 Yuan C，Mitsumori LM，Beach KW，et al.

Carotid atherosclerotic plaque：Noninvasive mr

characterization and identification of vulnerable

lesions[J]. Radiology，2001，221(2)：285-299.

6 Kelly-Hayes M，Beiser A，Kase CS，et al. The

influence of gender and age on disability following

ischemic stroke：The framingham study[J]. J Stroke

Cerebrovasc Dis，2003，12(3)：119-126.

7 李召晨，杜瑞艳，王洪娟，等. 颈动脉粥样硬化与急性

脑梗死关系的研究[J]. 中国现代医学杂志，2013，6：89-93.

8 熊建群，余琛，李应华. 颈内动脉形态异常与缺血性

脑血管病及颈动脉粥样硬化的关系[J]. 中华超声影像

学杂志，2012，21(7)：583-586.

9 Qin YQ，Chen AH，Tang XM. Echo-tracking

technology for evaluating the impact of blood pressure

on vascular endothelial function[J]. Nan fang yi ke da

xue xue bao，2012，32(3)：396-399.

10 刘娜，徐树军，陈业鹏，等. 老年高血压动态脉压与动

脉粥样硬化性脑梗死的关系研究[J]. 中国血液流变学

杂志，2014，24(1)：51-53.

11 Lind L，Peters SA，den Ruijter HM，et al. Effect

of rosuvastatin on the echolucency of the common

carotid intima-media in low-risk individuals：The

meteor trial[J]. J Am Soc Echocardiogr，2012，25(10)：

1120-1127.

12 Masson W，Siniawski D，Toledo G，et al. Estimation

of the "vascular age" based on body mass index in a

population in primary prevention. Association with

subclinical carotid atherosclerosis[J]. Medicina clinica，

2013，140(6)：255-259.

13 Howard G，Burke GL，Szklo M，et al. Active and

passive smoking are associated with increased

carotid wall thickness. The atherosclerosis risk in

communities study[J]. Arch Intern Med，1994，154(11)：

1277-1282.

14 West HW，Juonala M，Gall SL，et al. Exposure to

parental smoking in childhood is associated with

increased risk of carotid atherosclerotic plaque in

adulthood：The cardiovascular risk in young finns

study[J]. Circulation，2015，131(14)：1239-1246.

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