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目的:探讨老年原发性高血压静止性脑梗死与颈动脉颅外段狭窄的关系。方法::应用彩色多普勒超声检查仪检测老年原发性高血压合并静止性脑梗死组(n=50)和无静止性脑梗死组(n=114)患者的颈动脉颅外段血管管腔直径、内膜-中层厚度、斑块及狭窄程度。结果:老年高血压合并静止性脑梗死组患者颈动脉颅外段狭窄的发生率及粥样硬化斑块发生率分别为92.00%和82.00%,显著高于无静止性脑梗死组(64.91%和58.77%;P=0.000和P= 0.004);不稳定斑块发生率为38.00%,亦显著高于无静止性脑梗死组(7.02%,P=0.000)。与脑梗死病灶同侧的颈动脉颅外段狭窄发生率为69.84%,显著高于非梗死侧(35.1496,P=0.001.)。结论:老年原发性高血压病合并静止性脑梗死患者颈动脉颅外段狭窄和粥样硬化斑块,尤其是不稳定斑块有较高的发生率;颈动脉颅外段狭窄与颅内梗死病灶有同侧相关性。对老年原发性高血压病患者定期进行颈动脉彩色多谱勒超声检查,及早期发现颈动脉颅外段狭窄并采取相应措施,对预防缺血性脑血管病的发生有重要意义。
Objective: To investigate the relationship between elderly patients with essential hypertension with silent cerebral infarction and extracranial carotid stenosis. Methods: Color Doppler echocardiography was used to detect the extracranial carotid blood vessel in elderly patients with essential hypertension complicated with silent cerebral infarction (n = 50) and without static cerebral infarction (n = 114) Lumen diameter, intima-media thickness, plaque, and stenosis. Results: The incidence of carotid artery extracranial stenosis and the incidence of atherosclerotic plaque were 92.00% and 82.00% in elderly patients with hypertension complicated with silent cerebral infarction, which were significantly higher than those in patients without silent cerebral infarction (64.91% and 58.77%; P = 0.000 and P = 0.004). The incidence of unstable plaque was 38.00%, which was also significantly higher than that of the group without static cerebral infarction (7.02%, P = 0.000). The incidence of extracranial stenosis on the same side of cerebral infarction was 69.84%, which was significantly higher than that on the non-infarct side (35.1496, P = 0.001). Conclusion: The incidence of carotid artery extracranial stenosis and atherosclerotic plaque, especially unstable plaque in elderly patients with essential hypertension complicated with silent cerebral infarction have a high incidence. The stenosis of extracranial carotid artery is associated with intracranial Infarct lesions have ipsilateral correlation. Carotid color Doppler ultrasound in elderly patients with essential hypertension and early detection of extracranial carotid stenosis and take appropriate measures to prevent the occurrence of ischemic cerebrovascular disease is of great significance.