超声对老年高血压患者颈动脉结构及功能改变的评价

目的应用高频超声评价高血压级别、脉压对老年高血压患者颈动脉结构及功能的影响，探讨其诊断价值。方法应用高频超声观察83例老年高血压患者和25例健康老年人的颈动脉内-中膜厚度（IMT）、有无斑块、斑块数目；测量颈总动脉（CCA）舒张期和收缩期的内径，颈总动脉内-中膜厚度（CCA—IMT）、斑块大小；计算CCA斑块发生率、斑块Crouse积分、僵硬度、扩张性和顺应性等参数。结果高血压组的CCA内径、CCA—IMT、斑块检出率及Crouse积分均大于对照组（P〈0．05），且与高血压分级有较好的相关性，相关系数分别为r内径=0．689，rIMT=0．623，r斑块=0．611，r积分=0．635，P均〈0．05。脉压≤60mmHg者的CCA—IMT、斑块检出率和僵硬度均小于脉压〉60mmHg组（P〈0．05），扩张性和顺应性高于脉压〉60mmHg组（P〈0．05）。结论高血压级别、脉压对老年高血压患者的颈动脉结构及功能改变有显著影响。高频超声检查能及时准确评价颈动脉结构和功能变化的特征，是诊断动脉粥样硬化简便、有效、安全、无创的方法。

Evaluation of carotid artery structure and function changes in aged hypertension patients by ultrasound

Objective To explore diagnostic value of high-frequency ultrasound in carotid artery structure and function changes in aged hypertension patients. Methods Eighty - three aged hypertension patients and 25 health aged subjects were enrolled in this study. Their intima - media thickness（IMT） , position of plaques and number of plaques were observed by high- frequency uhrasound. The systolic and diastolic diameters of CCA, CCA-IMT and plaque size were measured, then the incidence of CCA plaques, plaques Crouse integration, stiffeness index, dilatancy and and compliance were calculated. Results The inner diameter of CCA, CCA-IMT, the plaques incidence and Crouse integration in hypertension groups were significant higher than those in control group（ P 〈 0.05 ）, and has good correlation to hypertension grading. The CCA-IMT, plaques incidence and the stiffeness index in PP ≤ 60 mm Hg group were significant lower than those in PP 〉 60 mm Hg group （ P 〈 0. 05 ）, and distensibility and compliance were higher than those in PP ≤ 60 mm Hg group （ P 〈 0.05 ）. Conclusion Hypertension grades and the pulse pressure has obvious influence on carotid artery structure and function changes in aged hypertension patients. High frequency ultrasound can accurately evaluate the features of carotid artery structure and function changes, it is an convenient, effective, safe and noninvasive method for diagnosing carotid artery atheroscleosis.