颈动脉超声在脑梗死与高血压患者颈部血管病变中的应用分析

Application analysis of the carotid artery ultrasound in carotid artery disease in patients with cerebral infarction and hypertension

目的通过对研究对象行颈动脉超声检查,探讨超声在脑梗死与高血压患者颈部动脉血管病变诊断中的应用价值。方法对268例脑梗死和(或)高血压患者(观察组)和90(人)例对照组体检健康人群(人)行颈动脉超声及实验室检查,用方差分析、χ~2检验、Logistic回归分析对检查结果进行分析比较。结果血管内膜粗糙、增厚和斑块病变检出率比较,观察组显著高于对照组,差异有统计学意义(P<0.05),且在颈动脉分叉处斑块最多见。观察组易损斑块多于对照组,差异有统计学意义(P<0.05)。血管狭窄病变以轻、中度为主,且第一组血管病变程度最严重。回归分析提示:高龄、高血压、冠心病、糖尿病与颈动脉斑块形成显著相关(P<0.05);且高龄、高血压、糖尿病是不同性质斑块的共同危险因素(P<0.05)。结论颈动脉超声检查对脑梗死与高血压患者颈动脉硬化和斑块敏感性强,检出率高,可作为筛查高危人群的常规方法 。

Objective To investigate the application value of carotid artery ultrasound in carotid artery disease in patients with cerebral infarction and hypertension. Methods Two hundred and sixty-eight patients with cerebral infarction or hyperrension （observation group） and 90 healthy people （control group） were enrolled and underwent the carotid ultrasound and laboratory examination. Variance analysis, χ2 test and Logistic regression analysis were used to compare the results of the examination. Results The comparison of detection rates of 3 kinds of intimal lesions （rogh, thickening, plaque）, the observation group was significantly higher than those of the control group （P〈0.05）, and the most common was carotid bifurcation plaques. The vulnerable plaque in observation group was more than that of the control group, the difference was statistically significant （P〈0.05）. Vascular stenosis disease was mainly mild and moderate, and the degree of stenosis of the first group was the most serious. Regression analysis suggested that： advanced age, hypertension, coronary heart disease and diabetes were significantly correlated with the formation of carotid plaque （P〈0.05）, and the advanced age, hypertension and diabetes were the common risk factors of different patches （P〈0.05）. Conclusion Carotid artery ultrasound is highly sensitive to carotid atherosclerosis and plaque, it has a high detection rate and can be used as a routine method for screening high risk population.