颈动脉内中膜厚度结合Framingham风险评分用于高血压患者危险分级的评估

Risk reclassification of atherosclerosis and cardiovascular diseases by measuring carotid intima-media thickness in hypertension patients

目的:通过测量颈动脉内中膜厚度(carotid intima-media thickness,CIMT)评估亚临床期动脉粥样硬化,以重新评估高血压患者原有危险分级。方法:选取住院患者94例,平均年龄(56.9±12.1)岁,其中女性64例(68.1%),均为初次发现并住院治疗的高血压患者以及因眩晕住院合并单纯高血压的患者,均无高血压导致的心血管系统并发症。对全部患者进行Framingham评分,并进行临床,生化,超声心动图以及高频超声检查并测量CIMT。结果:通过Framingham评分,60例(63.8%)患者被归于低风险组,22例(23.4%)被归于中风险组。在所有患者中,68例(72.3%)患者伴有CIMT增厚,包括低风险组36例(60.0%)和中风险组20例(90.9%),高风险组中CIMT增厚达100%(12例)。增加CIMT的测量可以将59.6%的患者重新归类,36例(60.0%)低风险组患者被归于中风险组,20例(90.9%)中风险组患者被归于高风险组。结论:高血压患者CIMT增厚有很高的发生率,且CIMT增厚能够提高心血管疾病危险性评估等级。

Objective：To evaluate the subclinical atherosclerosis and to confirm the effect in the risk classification in hypertension patients by measuring the carotid intima-media thickness（CIMT）.Methods：We chose 94 hypertension patients [（56.9 ±1 2.1 ）years]who were diagnosed and treated for the first time,all of the patients accepted clinical and biochemical examination,echocardiography,and the ultra-sound examination,CIMT was measured.Results：Sixty patients（63.8%）were classified to the low risk group and 22 patients（23.4%）were classified to the media risk group by the Framingham score.The in-creased thickness of the CIMT was observed in 68（72.3%）patients of all the patients including the low risk and media risk groups.Fifty-six patients（59.6%）were reclassified by measuring the CIMT.Thirty-six patients（60.0%）of the low risk group were reclassified to the media risk group and 20 patients（90.9%） of the media risk group were reclassified to the high risk group.Conclusion：Measuring the CIMT can be beneficial for risk reclassification in hypertension patients.