杨华 胡斌 刘月琴 陈华 王笑

[摘要] 目的 探討社区脑卒中筛查高危人群中颈动脉粥样硬化危险因素。 方法 选取2019年1～9月社区40岁以上脑卒中筛查高危人群档案53例，按颈动脉超声结果分为颈动脉正常组、颈动脉内膜增厚（无斑块形成）组、颈动脉粥样硬化斑块组，比较三组的BMI、血压、空腹血糖、糖化血红蛋白、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、同型半胱氨酸、糖化血红蛋白、高血压、糖尿病、吸烟等情况。 结果 三组比较可以发现，斑块组年龄显著高于正常组和增厚组，差异具有统计学意义（F=9.126，P<0.001）;斑块组男性比例、FBG高于正常组和增厚组，差异无统计学意义（χ2=0.367，P=0.832;F=0.143，P=0.867）;斑块组和增厚组高血压、糖尿病比例高于正常组，差异无统计学意义（χ2=2.505，P=0.286;χ2=2.186，P=0.335）。吸烟、BMI、SBP、DBP、FBG、HbA1c、TG、TC、LDL、HDL、HCY 三组之间差异无明显统计学意义（P>0.05）。脑卒中高危人群中三组BMI、TG均高于正常值。结论 脑卒中高危人群中年龄是颈动脉粥样硬化斑块形成的高危因素，改善生活方式、戒烟、降低BMI、TG、FBG等危险因素，有助于降低脑卒中危险性，强化控制血糖可能降低高危人群中颈动脉形成动脉粥样硬化斑块的风险。

[关键词] 脑卒中;颈动脉粥样硬化;超声;社区;危险因素

[中图分类号] R743.3          [文献标识码] B          [文章编号] 1673-9701（2020）16-0158-04

Analysis on the risk factors of carotid atherosclerosis in high-risk population of stroke in community

YANG Hua1， 2   HU Bin1， 2   LIU Yueqin1， 2   CHEN Hua1   WANG Xiao1， 2

1.Department of Nursing， Tongling Polytechnic， Tongling   244000， China; 2.Tongling Yangguang Community Health Service Centre in Anhui Province， Tongling   244000， China

[Abstract] Objective To explore the risk factors of carotid atherosclerosis among high-risk populations in community stroke screening. Methods From January 2019 to September 2019， 53 cases of screening files of stroke high-risk populations in the community over 40 years old were selected. According to the carotid ultrasound results， the patients were divided into normal carotid group， carotid intima thickening（no plaque formation） group， and carotid atherosclerotic plaque group. The BMI， blood pressure， fasting blood glucose， glycated hemoglobin， triglycerides， total cholesterol， low density lipoprotein cholesterol， high density lipoprotein cholesterol， homocysteine， glycated hemoglobin， hypertension， diabetes， and smoking were compared between the three groups of patients. Results Based on the comparison between the three groups， the age in the plaque group was significantly higher than that in the normal group and the thickening group， and the difference was statistically significant（F=9.126， P<0.001）; the proportion of males and FBG in the plaque group were higher than those in the normal group and thickening group， but there was no statistically significant difference（χ2=0.367， P=0.832; F=0.143， P=0.867）; the proportion of hypertension and diabetes in the plaque group and the thickening group was higher than that in the normal group， but the difference was not statistically significant（χ2=2.505， P=0.286; χ2=2.186， P=0.335）. There was no statistically significant difference in smoking， BMI， SBP， DBP， FBG， HbA1c， TG， TC， LDL， HDL， and HCY among the three groups（P>0.05）. The BMI and TG in the three groups of stroke high-risk population were higher than normal. Conclusion Age is a high-risk factor for carotid atherosclerotic plaque formation in high-risk stroke populations. Improving lifestyle， smoking abstention， reducing BMI， TG， FBG and other risk factors can help reduce the risk of stroke， and strengthening blood sugar control may reduce the risk of carotid artery atherosclerotic plaques in high-risk populations.

[Key words] Cerebral stroke; Carotid atherosclerosis; Ultrasound; Community; Risk factors

心脑血管疾病仍然是全球范围内主要的死亡原因。2016年，估计有4100万人死于非传染性疾病，占据总死亡人数（5700万）的71%，其中心脑血管疾病为1790万，糖尿病为160万[1]。动脉粥样硬化是众多心脑血管病的主要潜在病因，它从儿童期开始，并且是进行性发展。在临床上被称为亚临床动脉粥样硬化前，动脉粥样硬化通常几十年没有症状[2]。颈动脉粥样硬化常被称为“沉默杀手”，每年用于治疗脑血管病的直接费用和间接损失给国民带来了沉重的经济负担。……