超声技术检测高血压和缺血性脑血管病颈动脉粥样硬化斑块的临床意义

目的应用超声技术检测高血压病和缺血性脑血管病患者颈动脉粥样硬化斑块的临床意义,并对好发部位及狭窄程度性质作一分析。方法应用二维和多普勒血管技术,分别检测60例高血压和缺血性脑血管病患者和30例无高血压及脑血管病患者,颈动脉内膜—中膜厚度(IMT)、斑块总积分、斑块总面积及脑血流量。结果二维超声检测结果显示高血压和缺血性脑血管病患者组与对照组比较,颈动脉IMT、斑块总积分、斑块总面积均明显增高,与血压呈显著正相关,其差异具有显著性意义。而颈总动脉(CCA)、颈内动脉(ICA)、椎动脉(VA)狭窄程度显著高于对照组(P<0.05)。多普勒超声显示,高血压和缺血性脑血管病组患者CCA、ICA、VA血流量及脑血流量显著低于对照组(P<0.05),脑血流量与脑血管疾病的发生负相关。结论应用超声技术检测高血压和缺血性病患者颈动脉粥样硬化、斑块,有助于了解疾病的不同状态,便于判断病程及预后,对临床工作具有很大的指导意义。

Ultrasound Evaluation of Peripheral Atherosclerosis in Hypertention and Ischemia Cerebrovascular Disease

Objective To evaluate the clinical significance of peripheral atherosclerosis in patients with hypertention and ischemia cerebrovascular disease using vascular ultrasound,meanwhile analyze common position and the stenosis degree. Methods Carotid intima-media thickness(IMT),total plaque score,plaque area and cerebral blood flow were measured by vascular ultrasound in 60 patients with hypertention and ischemia cerebrovascular disease,and 30 patients without cardiovascular disease(the control).Results Carotid IMT,total plaque score and plaque area were higher in patients with hypertention and ischemia cerebrovascular disease than those of the control,and IMT was related to hypertention.The stenosis degree of the common carotid artery,internal carotid artery and vertebral artery in the patients with cerebrovascular disease were more severe than those of the control(P<0.05).Doppler imaging showed that the blood flow of the common carotid artery,internal carotid artery,vertebral and cerebral arteries in the patients with cerebrovascular were greatly decreased than those of the control(P<0.05).There was negative correlation between the total cerebral blood flow and occurrence of cerebrovascular disease.Conclusion The detection of peripheral atherosclerosis and plaque in patients with hypertention and ischemia cerebrovascular disease by vascular ultrasound was helpful for understanding the course and prognosis of disease,which was significant in the clinical.