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目的:探讨高血压病患者超声颈总动脉内径及血流动力学改变与脑梗死的关系及临床意义。方法:应用高频超声检测高血压病134例颈总动脉,将双侧颈总动脉内径均为<8mm、8~9mm或>9mm,划分为对照组48例、观察Ⅰ组54例、观察Ⅱ组32例。观察内膜中层厚度(IMT)、斑块发生率、血流收缩期峰值流速(PSV)、舒张末期血流速度(EDV)、血流阻力指数(RI)和脑梗死发生率,分析比较组间各指标的差异。结果:对照组、观察Ⅰ组硬斑发生率均显著高于观察Ⅱ组(P<0.05),对照组与观察Ⅰ组差异不显著(P>0.05);观察Ⅰ组、观察Ⅱ组颈动脉IMT增厚、软斑与混合性斑块发生率、斑块积分、病变检出率及脑梗死发生率均显著高于对照组(P<0.05),观察Ⅰ组与观察Ⅱ组差异不显著(P>0.05)。观察Ⅰ组和观察Ⅱ组的PSV及EDV均显著低于对照组(P<0.05),观察Ⅰ组与观察Ⅱ组差异不显著(P>0.05);3组间RI比较,差异不显著(P>0.05)。结论:高血压病颈总动脉内径>8mm时,颈动脉IMT增厚、软斑及混合性斑发生率、斑块积分与脑梗死发生率均显著增高。
Objective: To investigate the relationship between the diameter of the common carotid artery and the hemodynamic changes in patients with essential hypertension and cerebral infarction and its clinical significance. Methods: The common carotid arteries of 134 hypertensive patients were detected by high-frequency ultrasound. The internal carotid arteries of both common carotid arteries were all <8mm, 8 ~ 9mm or> 9mm, divided into control group (48 cases), observation group (54 cases) Group of 32 cases. IMT, plaque incidence, peak systolic velocity (PSV), end diastolic velocity (EDV), RI and incidence of cerebral infarction were observed and compared between groups Differences between the indicators. Results: In the control group, the incidence of severe plaque in group Ⅰ was significantly higher than that in group Ⅱ (P <0.05), while there was no significant difference between control group and observation group Ⅰ (P0.05). In group Ⅰ, the carotid IMT The incidence of thickening, soft plaque and mixed plaque, plaque score, the detection rate of lesions and the incidence of cerebral infarction were significantly higher than those of the control group (P <0.05). There was no significant difference between the observation group Ⅰ and the observation group Ⅱ (P > 0.05). The PSV and EDV in observation groupⅠandⅡ were significantly lower than those in control group (P <0.05). There was no significant difference between observation groupⅠ and observationⅡgroup (P> 0.05). There was no significant difference in RI between three groups > 0.05). CONCLUSION: When the diameter of common carotid artery of hypertension is greater than 8mm, the carotid IMT is thickened, the incidence of plaque and mixed plaque, plaque score and cerebral infarction are significantly increased.