糖尿病对老年高血压脑梗死患者颈动脉粥样硬化的影响

目的探讨老年高血压脑梗死患者合并2型糖尿病与颈动脉粥样硬化的变化及与复发性脑梗死的关系。方法彩色多普勒超声对170例老年高血压脑梗死患者的颈动脉进行检测。结果142例患者颈动脉有不同程度的粥样斑块形成。与高血压非糖尿病脑梗死组比较，高血压合并糖尿病组斑块以低回声软斑为主，其不稳定斑块的比例明显增高，P〈0．01。高血压合并糖尿病脑梗死组的复发构成比较高血压非糖尿病组为高，P〈0．01。结论糖尿病和高血压同时存在对颈动脉粥样硬化的发展有更大危害。彩色多普勒超声是检测颈动脉粥样斑块性质的有效方法，对合并2型糖尿病的老年高血压脑梗死患者常规定期监测，发现不稳定斑块（软斑和混合斑）积极治疗，预防复发。

Effect of Diabetes Mellitus on Carotid Atherosclerosis Plaque in Elderly Patients with Cerebral Infarction and Hypertension

Objective To investigate the relationship between Type 2 Diabetes mellitus and changes in carotid atherosclerosis as well as recurrent cerebral infarction in the elderly patients with cerebral infarction and hypertension. Methods Color Doppler ultrasonography was performed on the carotid artery in 170 elderly patients with cerebral infarction and hypertension. Results Various degrees of atheromatous plaques were observed in 142 patients. In the diabetes group, most of plaques were hypoechoic ,and the proportion of unstable plaques is significantly increased compared to that in the non - diabetes group, P 〈 0. 01. The proportion of recurrent cerebral infarction in the diabetes group was greater than that in the non - diabetes group, P 〈 0.01. Conclusion The coexistence of diabetes and hypertension increases the risk in the development of carotid atherosclerosis plaque. Color Doppler uhrasonography is a useful method for identification of carotid atherosclerosis plaque. Routine and periodic monitoring should be performed in the elderly patients with cerebral infarction, hyperten- sion and diabetes in order to identify the＇unstable plaques （i. e. soft plaque and complex plaque） ,thus providing active treatment to prevent the recurrence.