老年高血压患者颈动脉粥样硬化病变特点及影响因素

目的分析老年高血压患者颈动脉粥样硬化病变的特点及影响因素。方法对115例老年高血压患者、50例老年健康体检者晨起行空腹血糖和血脂测定,彩色多普勒超声检查颈动脉管腔内径(D)和内膜-中层厚度(IMT)并观察斑块发生情况;将高血压患者分别分为内膜正常、内膜增厚和斑块形成3组以及单纯高血压(P-EH)、高血压合并糖尿病(EH-T)、高血压合并高脂血症(EH-HL)3组,并分组观察。结果老年高血压组较对照组Glu、TC、TG以及LDL-C明显增高,颈动脉IMT明显增厚;大于平均年龄段的患者颈内动脉IMT明显增厚;高血压患者的BMI、Glu和LDL-C在颈动脉正常、内膜增厚及斑块3组间比较有显著性差异,且斑块组BMI、Glu明显高于内膜增厚组和正常组,斑块组LDL-C明显高于内膜增厚组;P-EH、EH-T、EH-HL3组间颈动脉IMT增厚程度及斑块检出率有显著性差异;斑块多累及颈总动脉分叉处、颈内动脉起始段,以纤维硬斑、低回声软斑多见。结论高血压、糖尿病、高脂血症、肥胖以及高龄等心血管病危险因素与颈动脉粥样硬化密切相关,应用彩色多普勒超声能动态直观地了解颈动脉粥样硬化的病变程度,是早期发现和筛选心脑血管疾病高危患者的必要手段。

The features and the influencing factors of carotid atherosclerosis in the eldly patients with hypertension

Objective To analyse the features and the influencing factors of carotid atherosclerosis in the eldly patients with hypertension.Methods Levels of fasting blood glucose and blood lipid were examined in 115 senile hypertensive patients and 50 controls.The carotid artery diameter(D) and intima-media thickness(IMT) were assessed with color Doppler ultrasound.115 patients with hypertention were divided into three groups(group with normal IMT,group with thicker IMT and group with plaque).They were also divided into pure-essential hypertention group(P-EH),hypertention with diabetes group(EH-T) and hypertention with hyperlipidemia(EH-HL).Results The levels of Glu,TC,TG and LDL-C were significantly higher in senile hypertensive patients.The carotid artery IMT were apparently thicker in senile hypertensive patients.Patients with ages above the average had obvious thicker IMT.There were significant differences of BMI,Glu and LDL-C among normal IMT,thicker IMT and plaque groups.Levels of BMI,Glu,LDL-C were apparently higher in plaque group.There were significant differences of the thicker degree of IMT and incidence rate of plaque among P-EH,ET-H and EH-HL groups.The plaques usually occurred on the fork part of common carotid artery and the initial part of internal carotid artery.Most of them were fibrostic hard plaques and low-echo plaques.Conclusion Cardiovascular diseases such as hypertention,diabetes,hyperlipidemia,obesity and growth of age were closely related with carotid atherosclerosis.It is conveniently to explore the degree of carotid atherosclerosis through color Doppler ultrasound.For early discovery and screening of high-risk patients with cardio-erebrovascular diseases,color Doppler ultrasound is the essential means.