高血压患者颈动脉粥样硬化病变与腔隙性脑梗死的关系

The relation between carotid atherosclerosis and lacunar infarction in hypertensive patients

目的探讨高血压患者颈动脉粥样硬化病变与腔隙性脑梗死的患病关系。方法选择住我院的111例高血压合并腔隙性脑梗死患者(腔隙性脑梗死组)和91例高血压非腔隙性脑梗死的患者(非腔隙性脑梗死组),均行头颅CT或MRI及多普勒超声检查,测定血脂等指标。结果logistic回归分析显示,收缩压升高、载脂蛋白A(apoA)降低与高血压患者合并腔隙性脑梗死有关(P<0.05)。高血压病程越长的患者越易发生腔隙性脑梗死。腔隙性脑梗死组颈动脉粥样斑块阳性动脉数较非腔隙性脑梗死组高(P<0.05);腔隙性脑梗死组的颈动脉内径较非腔隙性脑梗死组窄(P<0.05);腔隙性脑梗死组颈动脉脉冲指数、阻力指数明显较非腔隙性脑梗死组高(P<0.05)。结论收缩压升高、apoA降低、高血压病程延长、颈动脉粥样硬化病变可能与腔隙性脑梗死有关。

Objective To investigate the relation between carotid atherosclerosis and lacunar infarction in hypertensive patients. Methods 111 hypertensive patients with lacunar infarction and 91 hypertensive patients without lacunar infarction were given CT or MRI and carotid color Doppler examination. Results Increased systolic blood pressure, decreased apoA,high blood pressure history were correlated to lacunar infarction in hypertensive patients （ P 〈0.05）. The number of carotid arteries with plaque, the mean pulse index and resistance index of carotid artery in hyperten sive patients with lacunar infarction were higher than those in hypertensive patients wit＋hout la cunar infarction （ P 〈0.05）. The mean caliber of carotid artery in hypertensive patients with a cunar infarction was smaller than that in hypertensive patients without lacunar infarction （P〈 0.05）. Conclusions The increased systolic blood pressure, decreased apoA, long hypertension history and carotid atherosclerosis were likely correlated to lacunar infarction in hypertensive patients.