老年高血压患者颈动脉颅外段硬化与无症状性脑梗死

目的探讨老年原发性高血压无症状性脑梗死与颈动脉颅外段狭窄的关系。方法应用彩色多普勒超声检查仪检测老年原发性高血压合并无症状性脑梗死组(n=50)和无无症状性脑梗死组(n=114)患者的颈动脉颅外段血管管腔直径、内膜中层厚度、斑块及狭窄程度。结果老年高血压合并无症状性脑梗死组患者颈动脉颅外段狭窄的发生率及粥样硬化斑块发生率分别为92.0%和82.0%,显著高于没有无症状性脑梗死组(64.9%和58.8%;P=0.000和P=0.004);不稳定斑块发生率为38.0%,亦显著高于无无症状性脑梗死组(7.0%,P=0.000)。与脑梗死病灶同侧的颈动脉颅外段狭窄发生率为69.8%,显著高于非梗死侧(35.1%,P=0.001)。结论老年原发性高血压病合并无症状性脑梗死患者颈动脉颅外段狭窄和粥样硬化斑块,尤其是不稳定斑块有较高的发生率;颈动脉颅外段狭窄与颅内梗死病灶有同侧相关性。对老年原发性高血压病患者定期进行颈动脉彩色多谱勒超声检查,及早期发现颈动脉颅外段狭窄并采取相应措施,对预防缺血性脑血管病的发生有重要意义。

Extracranial Carotid Artery in Elderly Hypertension Complicated with Silent Cerebral Infarction

ObjectiveTo investigate the correlation between silent cerebral infarction (SCI) and extracranial carotid atherosclerosis (ECCAS) in elderly with essential hypertension. MethodsWTBZ]Using the colour Doppler ultrasonography technique, the lumen diameter, intima-media thickness, plaque and the extent of atherosclerosis in extracranial carotid artery were measured at both sides in elderly patients with essential hypertension in SCI group(n=50), and compared with those in without SCI group(n=114).ResultsThe incidence of ECCAS was significantly higher in SCI group than in without SCI group (92.0% vs 64.9%, P<0.001).The prevalence of carotid plaque, especially the vulnerable plaque was higher as well (82.0% vs 58.8%, P=0.004; 38.0% vs 7.0%, P=0.000).ECCAS was more frequent at the ipsilateral carotid artery with stroke focus than that in contralateral artery (69.8% vs 35.1%, P=0.001).ConclusionHigher prevalence rate of ECCAS and vulnerable carotid plaque were shown in the elderly with essential hypertension complicated silent cerebral infarction.Carotid artery ultrasound examination carried regularly to find early stage ECCAS is warranted.