高龄老年患者动脉及心脏结构与功能变化

目的评价高龄老年患者动脉及心脏结构、功能变化。方法老年高血压或糖尿病患者分为两组，高龄组：80岁及以上，119例；老年组：60—79岁，78例。分别检测颈动脉内膜中层厚度（IMT）、冠状动脉钙化积分（CS）、动脉脉压（PP）；心脏超声检测室间隔厚度（IVS）、左室室壁厚度（LVPW）、舒张末期左心室内径（LVDd）、收缩末期左心室内径（LVDs）、收缩末期左心房前后径（LAD）、左室质量（LVM）、左室质量指数（LVMI）、左室射血分数（EF）、左心室舒张早期二尖瓣最大血流速度E峰及舒张晚期二尖瓣最大血流速度A峰比值（E／A）。结果高龄组冠脉钙化总积分（TCS）、右冠脉钙化积分（CSRCA）、IMT、PP、LVPW较老年组增高（P〈0．01），E／A较老年组下降（P〈0．05）。结论老年期随增龄颈动脉内膜增生及左室肥厚进一步加重；高龄老人心脏舒张功能明湿下降，但对收缩功能影响不大；增龄导致的冠状动脉钙化更易侵犯右冠脉。

Structural and functional assessment of cardiovascular system in elderly patients

Objective To evaluate the functional and structural changes of cardiovascular system in elderly patients. Methods One hundred and ninety seven elderly patients with hypertension or diabetes were enrolled in our study. Patients were divided into elderly （60-79 years, 119 cases）, and very elderly （〉 80 years, 78 cases） group. All the patients underwent detailed evaluation of cardiovascular system including carotid ultrasound, echocardiography and coronary CT angiography. Results The total calcification score （TCS）, right coronary artery calcification score of （CSRCA）, intimamedia thickness （IMT）, pulse pressure （PP） and left ventricular posterior wall （LVPW） thickness were significantly increased in the very elderly patients than those in the elderly patients （P 〈0.05 ）, while E/A ratio significantly decreased in the very elderly group （P〈0.05）. Conclusions Arteriosclerosis in carotid artery and coronary artery develops with aging and left ventricular diastolic function decreased significantly with increasing age.