颈动脉粥样硬化改变在高血压病及高血压病并脑卒中的临床意义

CLINICAL MEANING OF ATHEROSCLEROSIS IN HYPERTENSION WITH OR WITHOUT STROKE

目的 :探讨高血压病及高血压病并脑卒中患者颈动脉粥样硬化的改变。方法 :将接受颈动脉超声检查的 1 80例患者随机分为 3组 :正常组 30例 ,原发性高血压病组 5 0例 ,高血压病并脑卒中组 1 0 0例 ;采用二维超声显像多普勒脉冲检测双侧颈总动脉 (CCA)、颈内动脉 (ICA)、颈外动脉 (ECA)、颈动脉分叉(BIF) ,计算中层内膜厚度、管腔内径、斑块发生率及Crouse积分。结果 :颈动脉内膜增厚、斑块形成的发生率在正常组、高血压病组、高血压病并脑卒中组依次为 2 3 3%、6 8.0 %、97.0 % (P <0 0 1 )。软斑及出血斑在高血压病并脑卒中组显著增加。Crouse积分三组分别为 1 9 0、1 32 4、4 41 1。硬化斑块的好发部位以颈总动脉及其分叉处最多 ,其次为颈内动脉。结论 :二维超声多普勒检测技术为无创性评估高血压对靶器官损害的一种有效方法 ,颈动脉粥样硬化分级可作为了解高血压对靶器官损害程度的方法 ,并为上述疾病的治疗提供可靠的依据。

Objective:To explore the atherosclerosis change in hypertensives with or without stroke.Methods:Thirty healthy people (control group),fifty hypertensive patients(hypertension group) and one hundred patients with hypertension and stroke (hypertension with stroke group) were given carotid color Doppler examination.Atherosclerosis degree in bilateral CCA,ICA,ECA and BIF was measured and the middle intimal thickness,inside diameter of the carotid,incidence rate of carotid atherosclerosis spot and Crouse scoring were calculated.Results:The incidence rates of carotid atherosclerosis spot in control,hypertension and hypertension with stroke groups were 23 3%,68.0% and 97.0%,respectively.The soft spots and bleeding spots in hypertension with stroke group remarkably increased ( P <0 01).The Crouse scorings in control,hypertension and hypertension with stroke groups were 19 0,132 4,441 1,respectively.Conclusion:The carotid color Doppler examination is an effective method for estimating hypertension damage to target organs and it can offer reliable basis for treatment of the diseases mentioned above.