高血压患者颈动脉粥样硬化病变与脑梗死关系的初步探讨

目的 初步探讨高血压及高血压伴糖尿病（DM）患者颈动脉病变与脑梗死的关系。方法 应用彩色多谱勒显像仪对48例非老年高血压患者、79例老年血压患者、37例老年高血压伴DM患者进行颈动脉检测，观察颈动脉病变与脑梗死及血脂、血凝的关系。结果 老年高血压组颈动脉斑块的检出率（63．3％）显著高于非老年高血压组（22．9％，P＜0．01），老年高血压伴DM组与老年高血压组比较差异无显著性。老年高血压组中，颈动脉内膜增厚组脑梗死发生率（66．7％）较颈动脉正常组（25．0％）增高（P＜0．05），与斑块组（36．0％）比较差异无显著性；老年高血压伴DM组中内膜增（66．7％）及斑块组（46．4％）脑梗死发生率均较颈动脉正常组（0．0％）高（P＜0．05）。老年高血压组及老年高血压伴DM组高血压病史与颈动脉病变呈正相关，血脂及纤维蛋白原（FIB）与颈动脉斑块呈正相关。结论 颈动脉超声对脑梗死的预测有一定的实用参考价值，应积极控制脑梗死的危险因素。

Relationship between cerebral infarction and intimal lesion of carotid artery in the patients of hypertension

Objective To study the relation of cerebral infarction with the intimal lesion of carotid artery in the patients of hypertension or hypertension combined with diabetes mellitus(DM). Methods Forty eight non senile patients of hypertension,79 in senile patients of hypertension,37 senile patients of hypertension and DM.Carotid artery was detected by color Doppler ultrasound. The possible relation between lesion of carotid artery and cerebral infarction as well as parameters of lipid and hemagglutination was investigated. Results The incidence rate of atheromatous plaque of carotid artery was higher in group of senile patients with hypertension (63 3%) than that in group of non senile patients with hypertension (22.9%, P <0.01). In group of senile patients with hypertension, the incidence rate of cerebral infarction was higher in group of intimal proliferation of carotid artery(66.7%) than that in normal group(25.0%, P <0.05), the incidence rate was no difference between groups of atheromatous plaque of carotid artery(36.0%) and intimal proliferation of carotid artery. In group of senile patients with hypertension and DM ,the incidence rate of cerebral infarction either in group of atheromatous plaque of carotid artery(46 4%) or in group of intimal proliferation of carotid artery (66 7%) was higher than that in normal group(0.0%, P <0.05).There was positive correlation between lesion of carotid artery and course of hypertesion in all detected senile patients. The lipid and fibrinogen level were also significant correlated with the incidence rate of atheromatous plaque of carotid artery. Conclusions Ultrasonic examination for carotid antery had reference value in forecast incidence of cerebral infarction.