老年高血压合并糖尿病患者颈动脉超声研究

目的观察老年高血压合并糖尿病患者颈动脉粥样斑块的超声声像图特点。方法老年患者80例，分为三组：单纯高血压组（EH组）29例，高血压合并糖尿病（EH合并DM组）21例，正常对照组30例。所有病例均接受颈动脉超声检查、血糖及血胰岛素超敏C反应蛋白（hs—CRP）。颈动脉观察指标包括：内膜中层厚度（IMT）及粥样斑块的厚度，并计算Crouse积分。结果与对照组比较，高血压者颈总动脉IMT、颈动脉分叉处IMT、Crouse积分显著增高；EH合并DM组颈总动脉IMT、Crouse积分显著高于EH组（P〈0．01）。颈动脉斑块积分与胰岛素抵抗指数（HoMA—IR）、体重指数（BMI）和空腹血糖呈正相关。结论超声能很好反映老年高血压合并糖尿病患者颈动脉粥样硬化的程度，糖尿病和高血压同时存在时可加速动脉粥样硬化的进展。

Carotid ultrasonography in elderly hypertension patients combined with diabetes

Objectives To investigate the ultrasonographic characteristics of carotid artherosclerosis in elderly hypertension patients combined with diabetes. Methods Eighty patients were divided into three groups： essential hypertension group （EH, n=29）, essential hypertension combined with diabetes group （EH＋DM, n=21）, and normotensive group （control, n=30）. All the subjects were examined with Doppler ultrasonography for carotid and blood test of glucose, concentration of serum insulin, and c-reaction protein. The intima-media thickness （IMT） and plaque of carotid arteries were measured on ultrasonography and Crouse score was calculated. Results The IMT both in common carotid and bifurcation carotid arteries, and carotid Crouse score were higher in patients with hypertension than those in the control group, and these parameters in DM combined with EH group were much higher than those in EH group （P〈 0.01）. The carotid Crouse score was positively correlated with insulin resistance index（HOMA-IP-）, body mass index（BMI） and fasting blood glucose. Conclusion Carotid ultrasonography reveals the extent of artery artherosclerosis in elderly hypertension patients combined with diabetes. Hypertension combined with diabetes may accelerate the process ofartherosclerosis.