1729例卒中高危人群颈动脉超声筛查结果分析

Analysis of Ultrasound Screening Results in 1729 Cases of Stroke in High-risk Groups

目的了解社区40岁以上卒中高危人群颈动脉粥样硬化情况，为卒中高危人群的干预措施提供依据。方法研究方法为横断面研究，采用知情自愿的原则，从辖区内抽取40岁以上的常住人口，用问卷筛选出1729例卒中高危人群，对所有高危人群进行体格检查、实验室检查及颈动脉超声检查（检测颈动脉内膜中层及斑块形态）。结果问卷筛查出高危人群1729例，其中男性453例（26.2%），女性1276例（73.8%），平均年龄为（58.8±9.6）岁。颈动脉超声显示异常的833例（48.2%），其中颈动脉内膜中层单纯增厚、颈动脉粥样硬化斑块分别为98例和735例，分别占总高危人群的5.7%和42.5%，分别占超声异常高危人群的25.1%和88.2%。按照年龄分层，40∽50岁、50∽60岁、60∽70岁和70岁及以上组左侧颈动脉内膜中层增厚（χ2=15.5，P=0.001）和右侧颈动脉内膜中层增厚（χ2=26.7，P＜0.001）发生率差异具有显著性；不同年龄组动脉粥样硬化斑块的比率差异也具有显著性（χ2=48.6，P＜0.001）。结论卒中高危人群中，颈动脉超声异常发生率较高，颈动脉内膜增厚和动脉粥样硬化斑块形成均有随着年龄增加而增多的趋势。

Objective To investigate carotid atherosclerosis in population over age 40 with high risk of stroke, and to provide scientiifc evidence for formulating intervention measures. Methods This study was a cross-sectional study, based on the principle of voluntariness and informed consent 1729 cases with high-risk of stroke were sampled from those residents with age more than 40 by using stroke questionnaire survey. All high-risk groups underwent medical examination, laboratory tests and carotid artery ultrasound examination （detection of carotid artery intima-media and plaque morphology）. Results In the 1729 high-risk cases, 453 cases were male （26.2%）, 1276 cases were female （73.8%）, with an average age of （58.8±9.6）. Carotid ultrasound showed 833 cases （48.2%） with abnormalities, including carotid intima-media （intima-media thickness, IMT） simple thickening were 98 cases （5.7% of the total high-risk population, 25.1% of ultrasound abnormalities）, the carotid artery atherosclerotic plaques were 735 cases （42.5% of the total high-risk population, 88.2% of ultrasound abnormalities）. Stratiifed by age, 40∽49, 50∽59, 60∽69, older than 70, 4 age groups on the left IMT thickening （χ2=15.5,P=0.001） and right IMT thickening （χ2=26.7,P〈0.001） were significantly different; for different age groups atherosclerotic plaque ratio was also a signiifcant difference （χ2=48.6,P〈0.001）. Conclusion In population with high risk of stroke, the rates of abnormal carotid ultrasound are high, and carotid intimal thickening and atherosclerotic plaque formation increase with age growing.