老年冠心病患者颈动脉结构和功能改变的特点

Characteristics of the structural and functional changes of common carotid artery in aged patients with coronary artery disease

目的 探讨老年冠心病患者颈动脉结构和功能改变的特点。方法 将 1 1 7例经冠状动脉造影确诊为冠心病的患者分为 2组 ,老年组患者年龄 >60岁 ,共 64例 ,非老年组患者年龄≤ 60岁 ,共 53例 ;用超声方法检测所有患者颈动脉内中膜厚度 (IMT)、粥样硬化斑块及内径 ,并以同时测量的肱动脉血压值计算颈动脉弹性特征指标 ;比较两组间上述各项指标的差异。结果 老年组患者颈动脉斑块发生率、颈动脉斑块数和颈动脉内径显著高于对照组 ,IMT亦有高于对照组患者的趋势 (有临界性统计学意义 ) ,而半径 IMT比值两组间无差异。老年组患者的动脉扩张性显著低于非老年组患者 ,而僵硬指数显著高于非老年组患者 ,弹性特征指标两组间无明显差异。结论 老年冠心病患者IMT均匀增厚及颈动脉代偿性重塑作用接近极限 ,但颈动脉粥样硬化斑块发生率持续增加、斑块数量持续增多。老年冠心病患者的颈动脉僵硬度显著增高 ,而扩张性系数显著降低 ,提示年龄增长的生理性作用对动脉功能仍有重要影响。

Objective To investigate the characteristics of the structural and functional changes of common carotid artery in aged patients with coronary artery disease(CAD).Methods One hundred and seventeen patients with CAD were divided into 2 groups according to age: aged group with age>60 years(64 patients), non aged group with age≤60 years(53 patients). The intima media thickness(IMT), plaque and its number and diameter of carotid artery were measured by ultrasound, and the ratio of radius to IMT(R/IMT) and elastic property parameters of carotid artery were calculated by relative equations according to systolic and diastolic diameter of common carotid artery and blood pressure measured at brachial artery simultaneously. These parameters were compared between 2 groups.Results The incidence of plaque and its number and diameter of carotid artery of aged patients were higher than those of non aged ones,and the ratio of radius to IMT was similar between the 2 groups. Distensibility coefficient was significantly lower and stiffness index was significantly higher in the aged patients. Conclusions ① Increase in IMT and compensatively remodeling of carotid approximate climax, but atherosclerosis is progressing in the aged patients with coronary artery disease. ② The physiologic effect of increased age still significantly influence the function of carotid artery in the aged patients with coronary artery disease.