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目的：探讨脑梗死患者颈动脉粥样硬化的危险因素。方法：选取148 例脑梗死患者作为实验组和同期住院的80 例非脑梗死疾病患者为对照组，检测并比较各组年龄、吸烟、血压、饮酒、糖尿病、血脂、同型半胱氨酸和磷脂酶A2 等指标，然后进行卡方检验、相关性和Logistic 回归分析。结果：实验组颈动脉粥样硬化检出率为82.43％，对照组为12.5%，其差异具有统计学意义(P＜ 0.05)。高龄、吸烟、高血压、高血脂、高同型半胱氨酸血症、高磷脂酶A2(LP-PLA2)血症是经动脉粥样硬化的危险因素，且血浆同型半胱氨酸水平、LP-PLA2 水平、血压与颈动脉斑块稳定性有关(P＜0.05)。结论：颈动脉粥样硬化是脑梗死的病理基础，与高龄、吸烟、高血压、高血脂、高同型半胱氨酸血症、高磷脂酶A2(LP-PLA2)血症有关，对高同型半胱氨酸血症、LP-PLA2 和高血压患者要关注其斑块的稳定性。

英文摘要:

Objective:To investigate the risk factors of cerebral infarction combined with carotid atherosclerosis.Methods:148 patients with carotid atherosclerosis were selected as the experiment group, and another 80 patients without cerebral infarction were selected as the control group. Then the age, smoking, hypertension, alcohol consumption, diabetes, blood lipids, homocysteine, phospholipase A2 and other related indicators were observed and compared between two groups.Results:The percentage of carotid atherosclerosis was 82.43% in the experiment group, which was higher than 12.5% in the control group, and the difference was statistically significant (P<0.05). Multivariate Logistic regression showed that the advanced age, smoking, hypertension, high blood lipids, homocysteine and plasma homocysteine levels, blood pressure and LP-PLA2 were the risk factors of cerebral infarction combined with carotid atherosclerosis. The plasma homocysteine and LP-PLA2 levels and blood pressure were related to the stability of carotid atherosclerosis plaque (P<0.05).Conclusion:Carotid atherosclerosis was the cause of cerebral infarction and related to the age, smoking, hypertension, high blood lipids, high homocysteine, plasma LP-PLA2 and homocysteine levels, blood pressure patients with high homocysteine levels, and phospholipase A2 anemia and high blood pressure should be paid attention to the stability of the plaques.

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