【摘要】 目的 :探讨高龄老人颈动脉粥样硬化超声结构和功能改变及相关关系。方法 :采用高分辨彩色多普勒和 B型超声 ,对 12 0名不同年龄组健康人和 119例 75岁以上老人 (75～ 10 0岁 ,男 67例 ,女 52例 )进行超声和临床检测。结果 :正常人各年龄组随年龄增长 ,颈动脉内 -中膜厚度 (IMT)和颈总动脉 (CCA)内径、颈内动脉 (ICA)内径递增 ,收缩期血流峰值 (Vs)、舒张末期血流峰值 (Vd)、剪切率 (SR)递减。直线回归表明 :年龄与 IMT、 CCA、 ICA内径正相关 ;与 Vs、 Vd、 SR负相关。 75岁以上老人心脑血管病组 [92例 ,(81.0±4.5)岁 ]与同龄非心脑血管病对照组 [2 7例 ,(83 .3± 5.8)岁 ]比较 ,IMT、斑块积分 (CPS)、阻力指数、收缩压、脉压、甘油三脂显著增高 (P均 <0 .0 50 ) ;Vd、 SR、高密度脂蛋白胆固醇 (HDL -c)显著降低 (P均 <0 .0 5)。多因素逐步回归分析表明 :高龄老人 IMT与 CPS、脉压正相关 ;与 SR负相关。斑块积分与 L DL -c正相关 ;与 HDL-c负相关。结论 :75岁以上老人颈动脉内 -中膜厚度、斑块增加与脉压、剪切率、血脂紊乱有直接影响。更多还原

【Abstract】 Objective:To study the ultrasonic con st ruction and function changes in aged persons with atherosclerosis of carotid art ery.Methods:B-mode and color Doppler ultrasound were used to examine 120 normal persons consisted of 57 male and 63 female(age 30～77) The other group consisted of 119 persons aging over 75 who were subdivided into 2 g roups.92 persons aging 81±4 5 years old who had cardiocerebrovascular diseases (CCVD),and 27 persons aging 83 3±5 8 who had no cardiocerebrovascular diseas es (No-CCVD).Results:The aging carotid arteries were characterized by i ncreased intima-media thickness(IMT),widened diameters of common carotid arter y (CCA) and internal carotid artery (ICA),lowered systolic velocity (Vs),end-di astolic peak velocity (Vd) and shear rate(SR) Ages revealed linear positive cor relations with IMT,diameter of CCA and ICA and negative correlations with Vs;Vd and SR.Among 119 cases over 75 years old,the IMT,carotid plaque score(CPS),pulsa tile index,systolic blood pressure,pulse pressure and,triglycerides in CCVD grou p were significantly higher than those in No-CCVD group ( P all <0 05);and Vd,SR,high-density lipoprotein cholesterol (HDL-c) in CCVD group were signi ficantly lower than those of No-CVCVD group( P all<0 05) Multiple regress ion stepwise analysis revealed that IMT was positive correlated with CPS and pul se pressure was negative correlated with SR.On the other hand CPS was positi ve correlated with LDL-c and negative correlation with HDL-c.Conclu sions:There are significant correlations of thickened IMT with increa sed CPS,augmented pulse pressure,and lowered SR respectively in subjects over 75 years.更多还原