老年人颈动脉粥样硬化临床特点及相关危险因素的研究

目的：探讨老年人颈动脉粥样硬化临床特点及其相关危险因素。方法：收集符合纳入标准的住院老年患者临床资料,颈动脉多普勒检测颈总动脉内中膜厚度（IMT）、斑块有无及性质、管腔狭窄程度。结果：（1）老年人群颈总动脉IMT异常者占50.53%;颈动脉斑块阳性者占78.7%;颈动脉狭窄者占20%,以轻度狭窄为主。（2）颈动脉斑块好发部位依次是左颈总分叉、左颈总动脉、右颈总动脉、右颈总分叉、颈动脉窦、左颈内动脉、右颈内动脉、右颈外动脉、左颈外动脉。（3）颈动脉斑块阳性人群合并高血压心肌梗塞脑血管意外和心脑血管事件率增加。（4）颈动脉IMT异常组较IMT正常组年龄、收缩压、甘油三酯,合并脑血管事件和心脑血管事件明显增加,同时颈总动脉IMT增厚伴颈动脉斑块阳性率、管腔狭窄率及斑块累及部位增加。结论：老年患者颈动脉粥样硬化的发病率高,斑块好发于颈动脉分叉、颈总动脉、颈内动脉,并以左侧常见。颈总动脉IMT异常组合并脑血管事件和心脑血管事件率明显增加,颈总动脉IMT增厚增加颈动脉斑块和管腔狭窄的发生率。

Investigation of the Carotid Atherosclerosis in Elderly Patients

Objective：To investigate the characteristics of carotid atherosclerosis in elderly patients. Methods：Subjects consisted of 305 elderly patients aged 65 years or older. Blood pressure, blood chemical parameters, height and body weight,medical history were examined. The mean common carotid artery intima-media thickness, the characteristics of the plaque and extent of luminal stenosis were measured by carotid artery ultrasonography. Results： （1）About 80 % elderly patients exhibit carotid plaque and half of them associated with abnormal common carotid IMT. （2）The Plaque lesions were most prevalent in the bifurcation, then the common carotid artery and internal carotid artery（3）The abnormal IMT group were older, with higher systolic blood pressure （SBP） and triglyceride （TC）, higher coexistence rate with cerebral vascular events and cardiovascular events. （4）The abnormal IMT group have higher stenosis and plaque prevalence rates and higher carotid plaque score than normal IMT group. Conclusion： The prevalence rates of carotid atherosclerosis was high in elderly patients,the plaque lesions were more prevalent in the bifurcation. The abnormal IMT group were older, with higher coexistence rate with cerebral vascular events and cardiovascular events. Common carotid IMT increase the prevalence rates of stenosis and plaque and carotid plaque scores.