颈动脉超声检查各指标与年龄和性别关系的分析

Relationship of carotid ultrasonography parameters with age and gender

目的探讨颈动脉超声检查各项指标与年龄和性别的相互关系。方法选择后循环缺血和急性脑梗死患者234例,其中<50岁22例,50~59岁55例,60~69岁76例,70~79岁58例,≥80岁23例;男性136例,女性98例。均行颈动脉彩色超声检查,记录颈动脉内膜中层厚度(CIMT)、颈动脉粥样斑块数量(CPNS)、颈动脉斑块最大厚度(CPMT)、颈动脉狭窄数量(CSN)和颈动脉狭窄程度评分(CSES)。同时检测颈动脉斑块超声回声强度,并依据回声强度分为无斑块组、软斑块组、混合斑块组和硬斑块组。分析各项指标与年龄和性别间的关系。结果不同年龄段患者CIMT、CPNS、CPMT、CSN和CSES比较,差异均有统计学意义(P<0.05,P<0.01);且随年龄增长各项指标均呈线性增长趋势(P<0.01)。CIMT(r=0.247,P=0.001)、CPNS(r=0.464,P=0.000)、CPMT(r=0.438,P=0.000)、CSN(r=0.168,P=0.010)和CSES(r=0.163,P=0.012)均与年龄呈正相关,但与70~79岁比较,≥80岁所有指标变化均不明显(P>0.05)。无斑块组、软斑块组、混合斑块组和硬斑块组患者的平均年龄分别为(56.34±9.27)岁、(63.41±10.25)岁、(68.18±10.02)岁和(71.41±9.49)岁,各组患者的年龄比较,差异有统计学意义(f=25.602,P<0.01),线性检验显示,差异也有统计学意义(f=74.703,P<0.01)。55~75岁不稳定斑块脱落风险较高,<55岁和>75岁则较低。男性患者CIMT、CPNS、CPMT和CSES均较女性明显升高(P<0.05,P<0.01)。女性患者无斑块和稳定斑块比例显著高于男性,不稳定斑块比例显著低于男性(P<0.01)。结论动脉粥样硬化程度随年龄增长而增加,但动脉斑块脱落风险在<55岁和>75岁相对较低,在55~75岁相对较高。男性动脉粥样硬化程度高于女性,且男性动脉斑块脱落风险也高于女性。

Objective To study the relationship of carotid ultrasonography parameters with age and gender.Methods Two hundred and thirty-four posterior ischemia and acute cerebral infarction patients(22 were<50 years old,55 were 50-59 years old,76 were 60-69 yearsold,58 were 70-79 years old and 23 were≥80 years old,136 were male and 98 were female)admitted to our hospital were included in this study.They underwent carotid artery color ultrasonography for measuring their carotid intima-media thickness(CIMT)and carotid plaque number scores(CPNS),carotid plaques maximum thickness(CPMT),carotid stenosis number(CSN),carotid stenosis everity scores(CSES).Meanwhile,the echo intensity of carotid plaque was detected and the patients were divided into plqeue-free group,soft plaque group,mixed plaque group and hard plaque group according to the echo intensity.The relationship of carotid ultrasonography parameters with age and gender was analyzed.Results A significant difference was detected in CIMT and CPNS,CPMT,CSN,CSES in different age patients(P<0.05,P<0.01).The CIMT and CPNS,CPMT,CSN,CSES showed a linear growth trend with the increasing age(P<0.01)and were positively related with age(r=0.247,P=0.001;r=0.464,P=0.000;r=0.438,P=0.000;r=0.168,P=0.010;r=0.163,P=0.012).No significant difference was detected in ultrasonography parameters between 70-79 years old and≥80 years old patients(P>0.05).The mean age of patients in the plaque-free group,soft plaque group,mixed plaque group and hard plaque group was 56.34±9.27,63.41±10.25,68.18±10.02 and 71.41±9.49 years old respectively.Linear test showed that the mean age of patients in the 4 groups were also significant different(f=25.602,P<0.01).The CIMT and CPNS,CPMT,CSES was significantly higher in male patients than in female patients(P<0.05,P<0.01).The ratio of no plaque and stable plaque was significantly higher while that of unstable plaques was significantly lower in female patients than in male patients(P<0.01).Conclusion The atherosclerosis increases with age.The risk for plaque loss is low betweent<55 years old and>75 years old and is high at the age of 55-75 years.The risk of atherosclerosis and plaque exfoliation is higher in male patients than in female patients.