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目的探讨引发鼻咽癌放疗后迟发性放射性脑损伤患者颈动脉斑块形成的相关因素。方法选取2010年1月-2012年12月我院收治的120例鼻咽癌放疗后迟发性放射性脑损伤(RILBI)患者为观察组,同时以同期体检中心健康查体的120例体检者作为对照组,对比观察2组颈动脉斑块的发生率。然后根据观察组患者颈动脉有无斑块分为2组,行颈动脉的内膜-中层厚度(IMT)多重回归,筛选颈动脉斑块形成的因素,然后采用非条件Logistic回归分析斑块形成的危险因素。结果斑块检出率观察组为63.3%,对照组为10.8%,2组差异有统计学意义(P<0.05);年龄、是否高血压病、TC分组及LDL分级是鼻咽癌放疗后迟发性放射性脑损伤患者颈动脉斑块形成的相关因素,而性别、血糖、是否患有糖尿病不是相关因素;经非条件Logistic回归分析显示年龄、SBP及LDL是RILBI患者颈动脉斑块形成的危险因素(OR=1.121,95%CI:1.001-1.255,P=0.048;OR=1.087,95%CI:1.004-1.177,P=0.039;OR=1.036,95%CI:1.017-1.055,P=0.000)。结论鼻咽癌放疗后RILBI患者颈动脉斑块形成的几率较大,年龄与SBP是颈动脉斑块形成的重要危险因素,LDL是相对次要危险因素,要定期随访,以期及时发现迟发性放射性颈动脉损伤。
Objective To investigate the related factors of carotid plaque formation in patients with delayed radiation-induced brain injury after radiotherapy of nasopharyngeal carcinoma. Methods From January 2010 to December 2012, 120 patients with delayed radiation-induced brain injury (RILBI) after radiotherapy in our hospital were enrolled as the observation group. At the same time, 120 healthy subjects in the same period The control group, compared the incidence of carotid plaque in two groups. Then according to whether the carotid artery plaques in the observation group were divided into two groups, the intima-media thickness (IMT) multiple regression of the carotid artery was used to screen the carotid plaque formation factors, then the non-conditional Logistic regression was used to analyze the plaque formation Risk factors. Results The detection rate of plaque was 63.3% in the observation group and 10.8% in the control group. There was significant difference between the two groups (P <0.05). Age, hypertension, TC group and LDL grade were delayed Carotid artery plaque formation in patients with radioactive brain injury associated factors, sex, blood glucose, whether or not suffering from diabetes is not related factors; non-conditional logistic regression analysis showed that age, SBP and LDL are RILBI patients with carotid plaque risk OR = 1.087, 95% CI: 1.004-1.177, P = 0.039; OR = 1.036, 95% CI: 1.017-1.055, P = 0.000) . Conclusion The incidence of carotid plaque in patients with RILBI after radiotherapy for nasopharyngeal carcinoma is high, and age and SBP are important risk factors for the formation of carotid plaque. LDL is a relatively minor risk factor and should be followed up regularly to find the delayed Radioactive carotid artery injury.