[1]冯莹印,高 晓,宋金玉,等.高脂血症与颈动脉粥样硬化斑块的关系研究[J].医学信息,2022,35(13):89-93.[doi:10.3969/j.issn.1006-1959.2022.13.019]
 FENG Ying-yin,GAO Xiao,SONG Jin-yu,et al.Relationship Between Hyperlipidemia and Carotid Atherosclerotic Plaque[J].Medical Information,2022,35(13):89-93.[doi:10.3969/j.issn.1006-1959.2022.13.019]
点击复制

高脂血症与颈动脉粥样硬化斑块的关系研究()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年13期
页码:
89-93
栏目:
论著
出版日期:
2022-07-01

文章信息/Info

Title:
Relationship Between Hyperlipidemia and Carotid Atherosclerotic Plaque
文章编号:
1006-1959(2022)13-0089-05
作者:
冯莹印高 晓宋金玉
(天津市第四中心医院放射科,天津 300140)
Author(s):
FENG Ying-yinGAO XiaoSONG Jin-yuet al.
(Department of Radiology,Tianjin Fourth Central Hospital,Tianjin 300140,China)
关键词:
颈动脉动脉粥样硬化斑块高脂血症缺血性卒中
Keywords:
Carotid arteryAtheroscleroticplaqueHyperlipidemiaIschemic stroke
分类号:
R543.5
DOI:
10.3969/j.issn.1006-1959.2022.13.019
文献标志码:
A
摘要:
目的 探讨高脂血症与颈动脉粥样硬化斑块特征的关系。方法 回顾性分析2011年5月-2015年12月中国动脉粥样硬化风险评估(CARE-Ⅱ)中584例因急性缺血性脑卒中或短暂性脑缺血发作行颈动脉高分辨MRI血管壁成像患者,测量并计算颈动脉平均管腔面积、平均管壁面积、平均管壁体积、平均标准化管壁指数、最大管壁厚度、平均管壁厚度,识别及测量脂质坏死核心、钙化、斑块内出血、纤维帽破裂、斑块表面溃疡,鉴定高危斑块,将患者分为高脂血症组和非高脂血症组,比较两组症状侧颈动脉粥样硬化斑块特征和临床特征,评估高脂血症与颈动脉斑块特征的相关性,分析颈动脉粥样硬化斑块特征与血脂成分的相关性。结果 584例患者高脂血症组351例(60.10%),非高脂血症组233例(39.90%);两组平均管腔面积、最大管壁厚度、平均管壁厚度、平均标准化管壁指数、脂质坏死核心及斑块内出血发生率、脂质坏死核心体积百分比比较,差异有统计学意义(P<0.05);Logistic回归分析显示,高脂血症与平均管腔面积、脂质坏死核心相关,与颈动脉斑块负荷、脂质坏死核心体积不相关;高水平总胆固醇与平均管腔面积负相关,与最大管壁厚度正相关,与斑块内出血的存在及AHA Ⅵ型斑块存在相关,高水平低密度脂蛋白胆固醇、高水平甘油三酯及低水平高密度脂蛋白胆固醇与颈动脉斑块特征均不相关。结论 高脂血症患者颈动脉粥样硬化更严重,未来缺血性卒中风险更高,尤其是高水平总胆固醇患者有更大几率出现高风险斑块,在临床管理中应重视。
Abstract:
Objective To investigate the relationship between hyperlipidemia and carotid atherosclerotic plaque characteristics.Methods A total of 584 patients with carotid artery high-resolution MRI angiography due to acute ischemic stroke or transient ischemic attack from May 2011 to December 2015 in the Chinese Atherosclerosis Risk Evaluation (CARE-Ⅱ) were retrospectively analyzed. The average lumen area, average wall area, average wall volume, average standardized wall index, maximum wall thickness, and average wall thickness of the carotid artery were measured and calculated. The lipid necrosis core, calcification, intra-plaque hemorrhage, fibrous cap rupture, and plaque surface ulcer were identified and measured. The patients were divided into hyperlipidemia group and non-hyperlipidemia group. The characteristics and clinical features of symptomatic carotid atherosclerotic plaque were compared between the two groups. The correlation between hyperlipidemia and carotid plaque characteristics was evaluated, and the correlation between carotid atherosclerotic plaque characteristics and blood lipid components was analyzed.Results There were 584 patients, 351 patients (60.10%) in the hyperlipidemia group and 233 patients (39.90%) in the non-hyperlipidemia group. There were statistically significant differences in the average lumen area, the maximum wall thickness, the average wall thickness, the average standardized wall index, the incidence of lipid necrosis core and intraplaque hemorrhage, and the percentage of lipid necrosis core volume between the two groups (P<0.05). Logistic regression showed that hyperlipidemia was correlated with the average lumen area and lipid necrosis core, but not with carotid plaque load and lipid necrosis core volume. High level of total cholesterol was negatively correlated with mean lumen area, positively correlated with maximum wall thickness, and correlated with the presence of intraplaque hemorrhage and AHA Ⅵ plaque. High level of low density lipoprotein cholesterol, high level of triglyceride and low level of high density lipoprotein cholesterol were not correlated with carotid plaque characteristics.Conclusion Patients with hyperlipidemia have more severe carotid atherosclerosis and higher risk of ischemic stroke in the future, especially patients with high level of total cholesterol have a greater chance of developing high-risk plaques, which should be paid more attention in clinical management.

参考文献/References:

[1]Benjamin EJ,Muntner P,Alonso A,et al.Heart disease and stroke Statistics-2019 update: A report from the American Heart Association[J].Circulation,2019,139(10):e56-e528.[2]王陇德,刘建民,杨弋,等.我国脑卒中防治仍面临巨大挑战——《中国脑卒中防治报告2018》概要[J].中国循环杂志,2019,34(2):105-119.[3]Arnold N,Koenig W.Atherosclerosis as an Inflammatory Disease-Pathophysiology,Clinical Relevance and Therapeutic Implications[J].Dtsch Med Wochenschr,2019,144(5):315-321.[4]Kurihara O,Kim HO,Russo M,et al.Relation of Low-Density Lipoprotein Cholesterol Level to Plaque Rupture[J].Am J Cardiol,2020,134:48-54.[5]Deng F,Mu C,Yang L,et al.Carotid plaque magnetic resonance imaging and recurrent stroke risk: A systematic review and meta-analysis[J].Medicine (Baltimore),2020,99(13):e19377.[6]Liu Y,Zhu Y,Jia W,et al.Association between lipid profiles and presence of carotid plaque[J].Sci Rep,2019,9(1):18011.[7]Visscher M,Moerman AM,Burgers PC,et al.Data Processing Pipeline for Lipid Profiling of Carotid Atherosclerotic Plaque with Mass Spectrometry Imaging[J].J Am Soc Mass Spectrom,2019,30(9):1790-1800.[8]Zhao X,Li R,Hippe DS,et al.Chinese Atherosclerosis Risk Evaluation(CARE II)study:a novel cross-sectional,multicenter study of the prevalence of high-risk atherosclerotic carotid plaque in Chinese patients with ischaemic cerebrovascular events-design and rationale[J].Stroke Vasc Neurol,2017,2(1):15-20.[9]Cai JM,Hatsukami TS,Ferguson MS,et al.Classification of human carotid atherosclerotic lesions with in vivo multicontrast magnetic resonance imaging[J].Circulation,2002,106(11):1368-1373.[10]Chu B,Kampschulte A,Ferguson MS,et al.Hemorrhage in the atherosclerotic carotid plaque:a high-resolution MRI study[J].Stroke,2004,35(5):1079-1084.[11]Ou HC,Chou WC,Hung CH,et al.Galectin-3 aggravates ox-LDL-induced endothelial dysfunction through LOX-1 mediated signaling pathway[J].Environ Toxicol,2019,34(7):825-835.[12]Bentzon JF,Otsuka F,Virmani R,et al.Mechanisms of plaque formation and rupture[J].Circ Res,2014,114(12):1852-1866.[13]Hou Q,Li S,Gao Y,et al.Relations of lipid parameters, other variables with carotid intima-media thickness and plaque in the general Chinese adults: an observational study[J].Lipids in Health and Disease,2018,17(1):107-115.[14]Wang A,Tian X,Zuo Y,et al.Association between the triglyceride-glucose index and carotid plaque stability in nondiabetic adults[J].Nutr Metab Cardiovasc Dis,2021,31(10):2921-2928.[15]Virani SS,Catellier DJ,Pompell LA,et al.Relation of cholesterol and lipoprotein parameters with carotid artery plaque characteristics:the Atherosclerosis Risk in Communities (ARIC) carotid MRI study[J].Atherosclerosis,2011,219(2):596-602.[16]Wang Y,Yao M,Zou M,et al.Relationship Between Serum Lipid Profiles and Carotid Intraplaque Neovascularization in a High-Stroke-Risk Population: A Cross-Sectional Study in China[J].J Am Heart Assoc,2021,10(22):e021545.[17]Wu Y,Lu X,Zhang L,et al.Correlation between carotid intima-media roughness and cardiovascular risk factors[J].Exp Ther Med,2019,18(1):49-56.[18]Zhao X,Wang H,Bo L,et al.Serum lipid level and lifestyles are associated with carotid femoral pulse wave velocity among adults: 4.4-year prospectively longitudinal follow-up of a clinical trial[J].Clin Exp Hypertens,2018,40(5):487-494.[19]Kawashiri MA,Tada H,Nomura A,et al.Mendelian randomization: Its impact on cardiovascular disease[J].J Cardiol,2018,72(4):307-313.[20]Van DenBouwhuijsen QJ,Vernooij MW,Hofman A,et al.Determinants of magnetic resonance imaging detected carotid plaque components: the Rotterdam Study[J].Eur Heart J,2012,33(2):221-229.[21]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.[22]Gao X,Song J,Watase H,et al.Differences in Carotid Plaques Between Symptomatic Patients With and Without Diabetes Mellitus[J].Arterioscler Thromb Vasc Biol,2019,39(6):1234-1239.[23]Zhao XQ,Hatsukami TS,Hippe DS,et al.Clinical factors associated with high-risk carotid plaque features as assessed by magnetic resonance imaging in patients with established vascular disease (from the AIM-HIGH Study)[J].Am J Cardiol,2014,114(9):1412-1419.

相似文献/References:

[1]陈玉媛,易爱姣,谭齐鸣,等.中青年冠状动脉粥样硬化患者颈动脉硬化的超声特征[J].医学信息,2019,32(02):175.[doi:10.3969/j.issn.1006-1959.2019.02.054]
 CHEN Yu-yuan,YI Ai-jiao,TAN Qi-ming,et al.Ultrasound Characteristics of Carotid Atherosclerosis in Young and Middle-aged Patients with Coronary Atherosclerosis[J].Medical Information,2019,32(13):175.[doi:10.3969/j.issn.1006-1959.2019.02.054]
[2]何庆芳,周 红.颈动脉及椎动脉因素与脑梗死的关系[J].医学信息,2021,34(12):82.[doi:10.3969/j.issn.1006-1959.2021.12.022]
 HE Qing-fang,ZHOU Hong.The Relationship Between Carotid and Vertebral Artery Factors and Cerebral Infarction[J].Medical Information,2021,34(13):82.[doi:10.3969/j.issn.1006-1959.2021.12.022]
[3]陈若梦,席晓燕,张向红,等.基于流固耦合的颈动脉血液流变力学作用特性分析[J].医学信息,2022,35(02):64.[doi:10.3969/j.issn.1006-1959.2022.02.016]
 CHEN Ruo-meng,XI Xiao-yan,ZHANG Xiang-hong,et al.Mechanical Properties Analysis of Carotid Hemorheology Based on Fluid-structure Interaction[J].Medical Information,2022,35(13):64.[doi:10.3969/j.issn.1006-1959.2022.02.016]

更新日期/Last Update: 1900-01-01