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目的探讨颈动脉超声和经颅多普勒超声(TCD)在高血压无症状颅内外动脉粥样硬化中的临床检查意义。方法 100例原发性高血压患者(无脑缺血相关症状和体征),对其均实施颈动脉超声和TCD联合检查,观察检查结果。结果本组100例患者中,颅内和颅外动脉存在粥样硬化改变患者共有65例,其余35例颅内和颅外动脉无动脉粥样硬化改变,存在颅内和颅外动脉粥样硬化改变患者所占比例为65.0%。颅内动脉狭窄发生率高于颅外颈动脉狭窄发生率,差异有统计学意义(P<0.05)。在颅内动脉检查结果中,结果显示颅内动脉中狭窄动脉数量为30条,其中大脑中动脉狭窄共12条,占40.0%;颈内动脉虹吸部狭窄8条,占26.7%;椎基底动脉狭窄共7条,占23.3%;大脑前动脉狭窄共3条,占10.0%。其中大脑中动脉狭窄在颅内动脉狭窄中所占比例最高。结论在原发性高血压患者中,过半的患者存在颅内和颅外动脉粥样硬化改变,采用颈动脉超声和TCD联合检测无脑缺血症状的高血压患者有助于发现其颅内和颅外颈动脉硬化病变情况,为临床防治提供参考。
Objective To investigate the clinical significance of carotid artery ultrasound and transcranial Doppler ultrasound (TCD) in asymptomatic extracranial arterial atherosclerosis in hypertensive patients. Methods 100 cases of patients with essential hypertension (no symptoms and signs of cerebral ischemia related) were performed carotid artery ultrasound and TCD combined examination, the test results were observed. Results In this group of 100 patients, there were 65 cases of atherosclerotic changes in the intracranial and extracranial arteries, and the remaining 35 cases had no atherosclerosis in the extracranial and extracranial arteries. There were intracranial and extracranial atherosclerosis Change the proportion of patients was 65.0%. The incidence of intracranial arterial stenosis was higher than that of extracranial carotid stenosis (P <0.05). In the results of intracranial artery examination, the number of stenotic arteries in intracranial arteries was 30, of which 12 were middle cerebral artery stenosis, accounting for 40.0%; stenosis of stenosis of internal carotid artery was 8, accounting for 26.7%; vertebrobasilar artery A total of seven narrow, accounting for 23.3%; anterior cerebral artery stenosis, a total of three, accounting for 10.0%. Middle cerebral artery stenosis in which the highest proportion of intracranial artery stenosis. Conclusion In patients with essential hypertension, more than half of patients have intracranial and extracranial atherosclerosis changes, the use of carotid ultrasound and TCD combined detection of cerebral ischemia in patients with hypertension contribute to the discovery of its intracranial and Extracranial carotid atherosclerosis, provide a reference for clinical prevention and treatment.