彩色多普勒超声在颈部血管检查中的价值

目的研究彩色多普勒超声在颈部血管检查中的作用。方法回顾性分析北京市武警总医院于2010年3月至2012年9月诊治的170例高血压伴糖尿病患者(高血糖组)的临床资料,对其双侧颈部血管内-中膜以及血管内部的硬化斑块进行彩色多普勒超声检查,同时检测斑块导致的管腔狭窄以及血流动力学变化。同期选择122例健康体检者作为对照组,比较两组超声检查结果及颈动脉粥样硬化斑块分布情况。结果高血糖组患者中颈动脉粥样硬化斑块多见于颈总动脉分叉处者86例(50.6%),其次为颈内动脉的起始段者16例(9.4%),见于椎动脉者2例(1.2%);对照组中颈动脉粥样硬化斑块多见于颈总动脉分叉处者12例(9.8%),其次为颈内动脉起始段者2例(1.6%),椎动脉处未见斑块,两组比较差异具有统计学意义(χ2=13.18,12.64,14.91,P<0.05)。对高血糖组中出现粥样硬化斑块的104例患者进行血流速度与管腔狭窄程度的分析得出,斑块不大时血流速度无明显改变,斑块较大时会导致管腔狭窄,血流加快。结论动脉粥样硬化斑块大小的进展速度可以通过彩色多普勒超声检查进行判断,可以尽早发现颈部血管病变的存在,为临床医师提供有力的诊断依据。

The Value of Color Doppler Ultrasound in Neck Vascular Examination

Objective To study the effect of color Doppler ultrasound in cervical vascular examination.Methods The clinical data of 170 patients with hypertension and diabetes(high blood glucose group) from Beijing General Hospital of Chinese People's Armed Police Forces from March 2010 to September 2012 were reviewed.Their bilateral carotid intima-media and vascular internal atherosclerosis plaque were tested by color Doppler ultrasound,and luminal stenosis and hemodynamic changes caused by the plaque were tested as well.At the same period,122 cases of healthy persons were selected as control group,the plaque distribution ultrasonography results and carotid atherosclerosis were compared between the two groups.Results Carotid atherosclerotic plaque was mostly seen in carotid artery bifurcation,86 cases in hyperglycemia group(50.6%),followed by the initial segment of internal carotid artery in 16 cases(9.4%),vertebral artery seen in 2 cases(1.2%);in the control group the carotid atherosclerotic plaques were more common in the carotid artery bifurcation,12 cases(9.8%),followed by 2 cases of the initial segment of internal carotid artery(1.6%),no plaque was seen in vertebral artery,the difference between the two groups was statistically significant(χ2 = 13.18,12.64,14.91,P < 0.05).As for the analysis of blood flow velocity and luminal stenosis in 104 cases of atherosclerotic plaque in patients with high blood sugar group,when the plaque was not big,there was no obvious change in blood flow velocity,larger plaque causes stenosis and accelerated blood flow.Conclusion The progress of atherosclerotic plaque size can be judged by the color Doppler ultrasound examination,which can discover the neck angiopathy as soon as possible,to provide diagnostic evidence for the clinicians.