中老年糖尿病患者短暂性脑缺血发作与颈动脉相关因素探讨

Study on the relative factors between transient ischemic attack and carotid artery in the middle-aged and elder diabetics

目的探讨中老年糖尿病患者短暂性脑缺血发作(TIA)与颈动脉的相关性。方法采用HP-5500彩色多普勒超声仪分别对TIA组和对照组颈内动脉、椎动脉、颅内动脉进行监测,观察颈动脉的狭窄程度、平均血流速度(Vm)、血管搏动指数(PI)。结果TIA组患者颈动脉狭窄出现的比例明显高于对照组(P<0.001),危险度以椎动脉最大。狭窄检出率100%,大脑中动脉37条,颈内动脉颅外段24条,大脑前动脉15条,椎动脉23条,大脑后动脉8条,其他部位8条。轻度狭窄47条,中度狭窄49条,重度狭窄19条。TIA组患者大脑前动脉、大脑中动脉、椎动脉血流速度快于对照组(P均<0.001)。结论中老年糖尿病TIA患者以椎动脉狭窄危险度最高,大脑中动脉狭窄发生率最高,以中度狭窄为主。

Objective It is to discuss the correlation between transient ischeknic attack （TIA） and carotid artery in the middle-aged and elder diabetics. Methods The carotid artery stenosis, mean blood flew velocity and blood vessel pulse index of internal carotid artery, vertebral artery and intracranial artery of TIA group and control group were detected and observed with HP - 5500 color Doppler ultrasonic diagnosis apparatus. Results The proportion of occurrence of carotid artery stenosis was higher in ITA group than that in control group （P 〈 0.001 ）, and the highest risk of stenosis was in the vertebral artery. The detection rate of stenosis was 100 %. Among these stenosis, there were 37 cases in the middle cerebral artery, 24 cases in extracranial part of carotid artery, 15 cases in anterior cerebral artery, 23 cases in vertebral artery, 8 cases in posterior artery and another 8 cases in other parts of artery. Among these 115 cases of artery stenosis, there are 47 cases of mild stenosis, 49 cases of moderate stenosis and 19 cases of severe stenosis. Blood flow velocity in anterior cerebral artery, middle cerebral artery and vertebral artery of TIA group was faster than that of control group （P〈 0. 001 ）. Conclusion Among these middle-aged and elder diabetics affected with TIA, the highest risk of stenosis is in the vertebral artery and the highest rate of stenosis is in the middle cerebral artery, mainly with moderate stenosis.