作者：李欣，席爱萍，桂艳红，尹天露，霍园园，郭俊艳，王珅

单位：

1.056002河北省邯郸市第一医院神经外科　 2.056002河北省邯郸市，河北工程大学附属医院美容中心　 3.056002河北省邯郸 市第一医院肾内科　 4.100000北京市，中国医学科学院医学信息研究所　 5.056002河北省邯郸市，河北工程大学附属放射治疗科 6.056001河北省邯郸市邯钢医院甲状腺科　 7.056002河北省邯郸市，河北工程大学附属医院骨科 通信作者：李欣，E-mail：309606906@qq.com　 王珅，E-mail：botany1987@126.com

Units：

1.Department of Neurosurgery, Handan First Hospital, Handan 056002, China 2.Beauty Center, Affiliated Hospital of Hebei Engineering University, Handan 056002, China 3.Department of Nephrology, Handan First Hospital, Handan 056002, China 4.Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100000, China 5.Department of Radiotherapy, Affiliated Hospital of Hebei Engineering University, Handan 056002, China 6.Department of Thyroid, Hangang Hospital, Handan 056001, China 7.Department of Orthopaedics, Affiliated Hospital of Hebei Engineering University, Handan 056002, China Corresponding author: LI Xin, E-mail: 309606906@qq.com; WANG Shen, E-mail: botany1987@126.com

关键词：

围绝经期; 骨密度; 颈动脉疾病; 斑块,动脉粥样硬化; 影响因素分析;

Keywords：

Perimenopause; Bone density; Carotid artery diseases; Plaque, atherosclerotic; Root cause analysis

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.310

Funds：

2022年度河北省医学科学研究课题计划项目（N20210936）

摘要：

目的 探讨骨密度对围绝经期女性发生颈动脉粥样硬化及颈动脉斑块易损性的影响。方法 选取2021年7—10月在河北工程大学附属医院体检中心进行体检的1 000例围绝经期女性，收集受试者临床资料、生化指标、骨密度T值及颈动脉粥样硬化、颈动脉易损斑块发生情况。采用多因素Logistic回归分析探讨围绝经期女性发生颈动脉粥样硬化及颈动脉斑块易损性的影响因素。结果 根据骨密度T值将受试者分为骨量正常组(n=361)、骨量减少组(n=380)和骨质疏松组(n=259)。骨量减少组、骨质疏松组有冠心病史者占比及颈动脉粥样硬化、颈动脉易损斑块发生率高于骨量正常组，骨质疏松组有冠心病史者占比及颈动脉粥样硬化、颈动脉易损斑块发生率高于骨量减少组(P<0.05)。根据是否发生颈动脉粥样硬化将受试者分为颈动脉粥样硬化组(n=667)和无颈动脉粥样硬化组(n=333)。颈动脉粥样硬化组有高血压史、冠心病史者占比高于无颈动脉粥样硬化组，骨密度T值低于无颈动脉粥样硬化组(P<0.05)；多因素Logistic回归分析结果显示，冠心病史和骨密度T值是围绝经期女性发生颈动脉粥样硬化的独立影响因素(P<0.05)。根据颈动脉斑块易损性将受试者分为颈动脉易损斑块组(n=585)和非颈动脉易损斑块组(n=415)。颈动脉易损斑块组有吸烟史、高血压史、冠心病史者占比高于非颈动脉易损斑块组，骨密度T值低于非颈动脉易损斑块组(P<0.05)；多因素Logistic回归分析结果显示，冠心病史和骨密度T值是围绝经期女性颈动脉斑块易损性的独立影响因素(P<0.05)。结论 伴有骨量减少、骨质疏松的围绝经期女性颈动脉粥样硬化、颈动脉易损斑块发生率升高，而骨密度是围绝经期女性发生颈动脉粥样硬化和颈动脉斑块易损性的影响因素。

Abstract：

【Abstract】　Objective To explore the effects of bone mineral density on carotid atherosclerosis and carotid plaque vulnerability in perimenopausal women. Methods A total of 1 000 perimenopausal women who underwent physical examination in Physical Examination Center, Affiliated Hospital of Hebei Engineering University from July to October 2021 were retrospectively selected as the study subjects. The clinical data, biochemical indexes, bone mineral density T value, the incidence of carotid atherosclerosis and carotid plaque vulnerability were collected. The influencing factors of carotid atherosclerosis and carotid plaque vulnerability in perimenopausal women were analyzed by multivariate Logistic regression analysis. Results The subjects were divided into the normal bone mass group (n=361) , osteopenia group (n=380) and osteoporosis group (n=259) according to bone mineral density T value. The proportion of subjects with coronary heart disease history, incidence of carotid atherosclerosis and carotid vulnerable plaque in osteopenia group and osteoporosis group were higher than those in normal bone mass group, the proportion of subjects with coronary heart disease history, incidence of carotid atherosclerosis and carotid vulnerable plaque in osteoporosis group were higher than those in osteopenia group ( P < 0.05) . The subjects were divided into carotid atherosclerosis group ( n=667) and non-carotid atherosclerosis group (n=333) according to whether they had carotid atherosclerosis. The proportion of subjects with hypertension and coronary heart disease history in carotid atherosclerosis group were higher than those in non-carotid atherosclerosis group, and bone mineral density T value was lower than that in non-carotid atherosclerosis group (P < 0.05) . Multivariate Logistic regression analysis showed that the history of coronary heart disease and bone mineral density T value were influencing factors of carotid atherosclerosis in perimenopausal women (P < 0.05) . The subjects were divided into carotid vulnerable plaque group (n=585) and the non-carotid vulnerable plaque group (n=415) according to carotid plaque vulnerability. The proportion of subjects with smoking, hypertension and coronary heart disease history in carotid vulnerable plaque group were higher than those in non-carotid vulnerable plaque group, and bone mineral density T value was lower than that in non-carotid vulnerable plaque group (P < 0.05) . Multivariate Logistic regression analysis showed that the history of coronary heart disease and bone mineral density T value were influencing factors of carotid plaque vulnerability in perimenopausal women (P < 0.05) . Conclusion Perimenopausal women with osteopenia or osteoporosis have increased incidence rates of carotid atherosclerosis and carotid vulnerable plaque. And bone mineral density is an influencing factor for carotid atherosclerosis and carotid plaque vulnerability in perimenopausal women.

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