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目的探讨冠心病患者颈动脉粥样硬化发生状况及相关因素。方法 250例患者,均进行冠状动脉造影检查,根据造影结果分为冠心病组(140例)和非冠心病组(110例),观察两组颈动脉、颈内动脉及颈外动脉内径、内-中膜厚度(IMT)以及斑块积分、Gensini积分情况。再将250例患者按照年龄段分为三组,其中中年期组(45~55岁)80例、老年前期组(56~65岁)86例、老年期组(66~78岁)84例,观察三组性别及糖尿病、高尿酸血症、斑块、高血压病、冠心病、脑梗死发生情况,依据线性回归观察高血压病、高尿酸血症、冠心病、糖尿病、脑梗死的OR值。结果冠心病患者颈动脉、颈内动脉及颈外动脉内径、IMT以及斑块积分、Gensini积分均高于非冠心病组,差异均具有统计意义(P<0.05)。中年期组、老年前期组、老年期组患者性别及糖尿病、高尿酸血症发生率比较差异无统计学意义(P>0.05);三组斑块、高血压病、冠心病、脑梗死发生率比较差异具有统计学意义(P<0.05)。针对各因素进行的线性回归分析,中年期糖尿病、脑梗死纳入回归方程,其中糖尿病的OR=14.939,P<0.05;脑梗死的OR=11.432,P<0.05。老年前期高血压病、糖尿病、冠心病纳入回归方程,其中高血压病的OR=3.014,P<0.05;冠心病的OR=2.956,P<0.05;糖尿病的OR=6.907,P<0.05。老年期高血压病、脑梗死、高尿酸血症、冠心病纳入回归方程,其中高血压病的OR=6.047,P<0.05;脑梗死的OR=7.590,P<0.05;高尿酸血症的OR=5.499,P<0.05;冠心病的OR=3.712,P<0.05。结论针对冠心病及由此造成的心脑血管疾病患者,应该进行定期的颈动脉超声检查,及时的预防和诊治,以降低中老年人高血压、脑梗死等疾病的发生率。
Objective To investigate the occurrence and related factors of carotid atherosclerosis in patients with coronary heart disease. Methods A total of 250 patients underwent coronary angiography. According to the results of angiography, they were divided into coronary heart disease group (140 cases) and non-coronary heart disease group (110 cases). The diameters of the carotid artery, internal carotid artery and external carotid artery - Intima-media thickness (IMT) as well as plaque integral, Gensini integral situation. Then, 250 patients were divided into three groups according to their age groups. Among them, there were 80 cases in the middle-aged group (45-55 years old), 86 cases in the elderly group (56-65 years old) and 84 cases in the elderly group (66-78 years old) The incidences of hypertension, hypertension, hyperuricemia, plaque, hypertension, coronary heart disease and cerebral infarction in the three groups were observed. The incidences of hypertension, hyperuricemia, coronary heart disease, diabetes mellitus and cerebral infarction were observed by linear regression value. Results The diameter, IMT, plaque score and Gensini score of carotid artery, internal carotid artery and external carotid artery in CHD patients were significantly higher than those in non-CHD patients (P <0.05). There was no significant difference in gender, diabetes mellitus, and hyperuricemia between the middle-aged group, the elderly group and the elderly group (P> 0.05). The incidence of plaque, hypertension, coronary heart disease and cerebral infarction The difference was statistically significant (P <0.05). Linear regression analysis of each factor, middle-aged diabetes, cerebral infarction included regression equation, including diabetes OR = 14.939, P <0.05; OR = 11.432 cerebral infarction, P <0.05. Hypertension, diabetes and coronary heart disease were included in the regression equation. The OR of hypertensive disease was 3.014, P <0.05. The OR of coronary heart disease was 2.956, P <0.05. The OR of diabetes was 6.907, P <0.05. Senile hypertension, cerebral infarction, hyperuricemia, coronary heart disease included regression equation, including hypertension OR = 6.047, P <0.05; OR of cerebral infarction was 7.590, P <0.05; OR of hyperuricemia = 5.499, P <0.05; OR of coronary heart disease was 3.712, P <0.05. Conclusion Coronary heart disease and the resulting cardiovascular and cerebrovascular diseases should be carried out on a regular basis carotid ultrasound, timely prevention and treatment to reduce the incidence of hypertension, cerebral infarction and other diseases in the elderly.