| Research background:Cerebrovascular disease is a common disease in the world which has extremely affected the quality of patients' lives,known as the “killer of disease”.With the development of society,its incidence is still rising year by year and it has exceeded the tumor,becoming the first fatality rate of the disease.Carotid atherosclerosis(CAS)is one of the major causes of stroke,embolism caused by rupture or shedding of carotid plaques and secondary thrombosis are common reason of cerebral vascular stenosis which lead to brain insufficiency.Ultrasonography can easily,noninvasively and reliably indicate the occurrence,quantity,location and stenosis of carotid plaques and observe plaque characteristics,evaluate its stability and provide the basis for early prevention and early intervention for stroke.Objective:This study was based on the high risk population of stroke over the age of 40,to observe the carotid atherosclerosis,the nature of plaque and the degree of stenosis and analyze the risk factors associated with high risk population of stroke,to provide new ideas and methods for the prevention and treatment of stroke and to investigate the value of color Doppler ultrasonography in the detection of carotid atherosclerotic plaques in high-risk groups of stroke patients.Method:The high-risk population aged over 40 years old(including 40 years old)in the Physical Examination Center of the Third Affiliated Hospital of Qiqihar Medical University from December 2016 to June 2017 was selected,the carotid plaques were examined by color Doppler ultrasonography,data were extracted from 443 cases,including the incidence,nature,quantity,location and carotid stenosis of carotid plaques in the population were analyzed.Data were analyzed using SPSS21.0 software,count data were expressed by using the "rate" and "composition ratio",using chi 2 test or Fisher exact probability method to complete the comparison between groups;statistical data were used to describe the median and upper and lower four quantiles,and the rank sum test was used to compare between groups.Results:(1)The positive rate of diabetes is the highest in 443 high-risk groups,accounting for 68.4%;the second is the positive rate of dyslipidemia,accounting for 67.9%;The positive rate of overweight and obesity was 65.2%;The positive rate of hypertension was 64.3%;The positive rate of smokers was 32.5%;The positive rate of excessive drinking was 31.4%;The positive rate of lack of exercise was 30.7%;The positive rate of coronary heart disease was 16.3%;The positive rate of AF / valvular disease was the lowest,2.9%.(2)Plaque detection rate: in this study,a total of 299 cases of plaques were detected(67.5%).The male detection rate of plaques was 72.6%,higher than female detection rate of plaques 60.3%(?2=7.371,P=0.007);Different age plaque detection rate difference was statistically significant(?2=60.895,P<0.001),the plaque detection rate of 70 years old age was the highest,accounting for 85.7%;81.2%smokers had higher prevalence of plaque than 60.9% non-smokers(?2=18.401,P<0.001).The prevalence rate of plaque in excessive drinking crowd was 78.4%,higher than that of 62.5% non drinkers(?2=11.015,P=0.001).The prevalence of plaque in 206 overweight / obese persons(71.3%)was higher than that in 93 normal / lean subjects(60.4%)(?2=5.431,P=0.0.020);The detection rate of plaque in diabetic population(70.6%)was higher than that in non diabetics(60.7%)(?2=4.289,P=0.038);The detection rate of plaque in dyslipidemia group(71.4%)was higher than that in non dyslipidemia group(59.2%)(?2=6.625,P=0.010);The detection rate of plaques in hypertensive patients(71.6%)was higher than that in non hypertensive subjects(60.1%)(?2=6.077,P=0.014);The detection rate of plaque in CHD patients(44.4%)was lower than that in non CHD patients(72%)(?2=20.820,P<0.001);There was no statistical difference between AF / valvular disease(76.9%)and no AF/valvular disease(67.2%)(?2=0.190,P<0.663);There were significant statistically differences in the number of risk factors and the incidence of plaques(?2=75.039,P<0.001),the rate of plaque detection increased with the variety of exposure risk factors.(3)Plaque nature: In this study,a total of 299 subjects with plaques were examined,there were 127 cases with low echo plaques,accounting for 42.5% of the total plaques,there were 80 cases with hyperechoic plaques,accounting for 26.7% of the total plaques,unstable plaques were found in 92 cases,accounting for 30.8% of the total plaques.The difference of plaques between hypertensive and non hypertensive patients was statistically significant(?2=0.806,P=0.033).Age,gender,smoking,overweight/obese,excessive drinking,diabetics,dyslipidemia,hypertensive,CHD,AF / valvular disease and the number of risk factors were not statistically different from those of plaques(P>0.05).(4)Plaque number: Plaque was detected in 299 cases,there were 137 male cases(72.9%),which were more prone to develop multiple plaques than female with 67 cases(60.4%)(?2=5.040,P=0.025);The number of plaques in different age groups was different(P=0.001),and 60-70 years old group is the most vulnerable to develop multiple plaques;Smoking group(90.6%)were more likely to develop multiple plaques than non-smokers(53.8%)(?2=44.375,P<0.001);Excessive drinking group(91.7%)likely to develop multiple plaques than non-drinkers(54.7%)(?2=43.757,P<0.001).People lacking physical exercises(82.5%)were more likely to develop multiple plaques than people who did not lacking(61.4%).Overweight / obese people(84.5%)were more likely to develop multiple plaques than normal/lean people(32.3%)(?2=80.564,P<0.001);Non-diabetics(84.7%)were more likely to develop multiple plaques than diabetic(61.7%)(?2=14.876,P<0.001).Non dyslipidemia people(86.9%)were more likely to develop multiple plaques than dyslipidemia(60.9%)(?2=18.799,P<0.001).Non hypertensive people(90.5%)were more likely to develop multiple plaques than hypertension(57.8%)(?2=31.939,P<0.001);There were statistically significant differences in the number of exposures to different plaque types(?2=53.591,P<0.001);The number of plaques increased with the type of risk factors,and there was no significant difference between plaque number and coronary heart disease,atrial fibrillation / valvular disease(P>0.05).(5)Plaque position: The incidence of bilateral plaques was higher in males(88.8%)than in females(75.7%)(?2=8.961,P=0.003).The location of plaques in different age groups was statistically significant(?2=8.831,P=0.003).The bilateral incidence of plaque increased with age.The incidence of bilateral plaque increased in smokers(95.7%)more than non-smokers(76.4%)(?2=19.793,P<0.001);The incidence of bilateral plaque increased in drinkers(96.3%)than non-drinkers 146(76.8%)(?2=19.520,P<0.001).The incidence of bilateral plaques in overweight / obese people(92.7%)were more than normal / lean people(64.5%)(?2=37.816,P<0.001).The incidence of bilateral plaques was higher in non-diabetic people(94.1%)than diabetics(79.9%)(?2=9.117,P=0.003).The incidence of bilateral plaque was higher in non lipid abnormal population(96.4%)than dyslipidemia people(79.1%)(?2=13.506,P<0.001).The incidence of bilateral plaques was higher in non hypertensive people(95.8%)than hypertensive people(78.4%)(?2=14.492,P<0.001).With the increase of risk factors,the incidence of bilateral plaques increased(?2=21.031,P<0.001).Coronary heart disease and atrial fibrillation,and plaque location were not statistically significant There was no significant difference between plaque location and coronary heart disease,atrial fibrillation / valvular disease.(6)Carotid stenosis: In this study,there were 24 cases of carotid stenosis in this study.The incidence of Carotid stenosis was higher in smokers(16.2%)than non smokers(2.7%)(?2=17.561,P<0.001);The incidence of Carotid stenosis was higher in excessive drinkers(12.8%)than non drinkers(5.3%)(?2=5.392,P=0.020);The incidence of Carotid stenosis was higher in overweight/obese people(11.7%)than normal/lean people(0%)(?2=11.781,P=0.001);The relationship between the number of risk factors and the stenosis was statistically significant(?2=11.728,P=0.003),stenosis increased with increased types risk factors There was no statistical difference between carotid stenosis and the risk factors including age,gender,hypertension,diabetic,dyslipidemia(P>0.05).Conclusion:1.The highest positive risk factors in the population with high-risk of stroke was diabetes,and the detection rate of carotid atherosclerosis was 96.6% in those with more than 5 risk factors.2.The rate of bilateral and multiple plaques were high in men,elderly,smoker,excessive drinkers,overweight/obese,or people with more risk factors.3.The rate of carotid stenosis were high in smoker,excessive drinkers,overweight/obese,or people with more risk factors.4.People with high blood pressure tended to have hyperechoic plaques,while those without high blood pressure tend to have low echo plaques. |
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