颈动脉粥样硬化与老年退行性心脏瓣膜病的相关性研究

Correlation analysis of carotid atherosclerosis and senile degenerative heart valvular disease

目的：通过高频超声对老年患者颈动脉及超声心动图检查,探讨颈动脉粥样硬化与老年退行性心脏瓣膜病的相关性。方法：选择88例老年退行性心脏瓣膜病患者作为研究组,49例无老年退行性心脏瓣膜病患者作为对照组。检测并比较2组患者二尖瓣和主动脉瓣情况、颈动脉内-中层厚度（IMT）及颈动脉粥样硬化斑块情况。结果：研究组患者IMT、斑块积分、斑块检出率均高于对照组（P〈0.05~P〈0.01）。研究组管腔闭塞率2.27%,管腔狭窄率90.91%;对照组无管腔闭塞,管腔狭窄率18.37%;2组患者管腔闭塞率差异无统计学意义（P=0.573）,研究组患者管腔狭窄率明显高于对照组（P〈0.01）;研究组合并冠心病、高血压、糖尿病及高脂血症率均明显高于对照组（P〈0.01）。结论：颈动脉粥样硬化与老年退行性心脏瓣膜病变有密切关系,颈动脉粥样硬化程度随心脏瓣膜钙化程度的加重而加重,对于老年退行性心脏瓣膜病患者应行颈动脉超声检查。

Objective： To explore the correlation of carotid atherosclerosis and degenerative valvular heart disease through highfrequency ultrasound carotid and echocardiographic examination in elderly patients. Methods： Eighty-eight cases of degenerative valvular heart disease were selected as the study group,49 cases of non-degenerative valvular heart disease as control group,the states of mitral and aortic valve,the internal-middle thickness（ IMT） in carotid artery and carotid atherosclerotic plaques were measured and compared in the two groups. Results： The IMT,plaque score,plaque detection rate were higher in study group than in control group（ P 0. 05 to P〈0. 01）. In study group,the obliteration rate was 2. 27%,the stenosis rate was 90. 91%; in control group,there were no luminal occlusion,the stenosis rate was 18. 37%,there was no statistical difference of the obliteration rate in the two groups（ P =0. 573）,while the stenosis rate in study group was significantly higher than in control group（ P〈0. 01）; the complications of coronary heart disease,hypertension,diabetes and hyperlipidemia were significantly higher in study group（ P〈0. 01）. Conclusions： There are the close relationship between carotid atherosclerosis and degenerative changes in heart valve,the degree of carotid atherosclerosis are increased with the degree of heart valve calcification,carotid atherosclerosis ultrasound should be performed for senile patients with degenerative heart valve disease.