老年原发性高血压合并无症状性脑梗死的脑血管评估

目的：探讨老年原发性高血压静止性脑梗死与颅内-外动脉狭窄的关系。方法：对86例老年原发性高血压合并静止性脑梗死患者的数字减影血管造影（DSA）和彩色多普勒超声（Duplex）检查资料进行分析。计算颅内-外动脉狭窄率及斑块未检出率，并对DSA和Duplex检查进行比较。结果：86例患者颈动脉颅外段斑块检出率高于正常对照组（62．79％，24．00％，P〈0．01）。86例患者中，单纯颅外动脉、颅内动脉及颅内-外动脉多发性狭窄或闭塞发生率分别为43．02％（37／86）、16．82％（14／86）和27．91％（24／86）。颅外动脉狭窄或闭塞发生率高于颅内动脉（70．93％，44．19％，P〈0．001）。Duplex对颈动脉颅外段狭窄检查结果与DSA差异不显著（P〉0．05）。结论：在老年原发性高血压合并静止性脑梗死患者中，颈动脉颅外段狭窄有较高的患病率。对老年原发性高血压患者定期进行颈动脉Duplex超声检查，可早期发现颈动脉颅外段狭窄并采取相应措施，对预防缺血性脑血管病有重要意义。

Evaluation of cerebral vessels of the elder with essential hypertension complicated silent cerebral infarction

Objective:To analyze the correlation between intra-extracranial arterial stenosis and silent cerebral infarction(SCI) in the elder with essential hypertension(EH). Methods:The results of color duplex ultrasonography(Duplex) and digital subtraction angiography(DSA) examination of 86 patients with essential hypertension complicated silent cerebral infarction were analyzed.The incidence of intra-and extracranial arterial stenosis and arthrosclerosis plaque were calculated.The comparative value of Duplex and DSA for evaluating atherosclerosis of extracranial carotid artery was analyzed using statistic methods. Results:The incidence of arthrosclerosis plaque was higher in SCI group than that in normal control group(62.79%,24%,P<0.01),43.02% of the SCI patients had either extracranial artery occlusion or stenosis,16.82% of the patients had either intra cranial artery occlusion or stenosis,27.91% of the patients had multiple intra and extracranial arteries occlusion or stenosis.There were more patients with extracranial stenosis than intracranial stenosis(70.93%,44.19%).Duplex scanning was highly accurate for evaluating extracranial carotid arthrosclerosis. Conclusion:There was a high incidence of extracranial carotid artery stenosis in the elder with essential hypertension complicated silent cerebral infarction.The carotid artery Duplex examination should be performed regularly to the elder with essential hypertension in order to find out extracranial carotid artery stenosis at early stage.