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高血壓對(duì)腦卒中高危人群頸動(dòng)脈粥樣硬化發(fā)生的影響及其病機(jī)探討

發(fā)布時(shí)間:2018-06-24 來源: 短文摘抄 點(diǎn)擊:


  [摘要] 目的 分析高血壓對(duì)腦卒中高危人群頸動(dòng)脈粥樣硬化發(fā)生的影響及其病機(jī)。方法 方便選擇2011年1月—2015年12月該院收治的210例腦卒中高危人群,根據(jù)有無高血壓作為分組標(biāo)準(zhǔn)分為試驗(yàn)組146例和對(duì)照組64例,分析兩組一般資料、CCA-IMT情況、頸動(dòng)脈斑塊檢出情況以及病程與疾病進(jìn)展的關(guān)系。結(jié)果 試驗(yàn)組與對(duì)照組在年齡、性別、吸煙史、體重指數(shù)方面差異無統(tǒng)計(jì)學(xué)意義(P>0.05),具有可比性。對(duì)照組和實(shí)驗(yàn)組左右側(cè)CCA-IMT增厚檢出率分別為39.06%、32.81%和60.96%、46.58%,試驗(yàn)組檢出率明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。高血壓病程與CCA-IMT增厚存在相關(guān)性,病程增加,內(nèi)膜增厚比例增加(χ2=9.304,P<0.05)。高血壓病程與頸動(dòng)脈斑塊檢出存在一定關(guān)系,隨著高血壓病程增加,頸動(dòng)脈斑塊檢出率增加(χ2=10.344,P<0.05)。結(jié)論 臨床需加強(qiáng)腦卒中的篩查防治工作,特別是針對(duì)伴有高血壓的腦卒中高危人群,積極采取有效的預(yù)防與治療措施,將降低腦卒中的發(fā)生。
  [關(guān)鍵詞] 高血壓;頸動(dòng)脈粥樣硬化;影響與病機(jī)
  [中圖分類號(hào)] R4 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742(2018)01(c)-0068-03
  [Abstract] Objective This paper tries to analyze the effect of hypertension on carotid atherosclerosis and its pathogenesis. Methods 210 cases of high-risk of stroke in this deparment from January 2011 to December 2015 were selected, and divided into two groups by having hypertension or not, 146 cases in the trial group, and 64 cases in the control group. The relationship between the disease progression with the general information, CCA-IMT and the carotid plaques was analyzed. Results The difference in age, gender, smoking history and body mass index of the two groups were not significant. There was no statistical significance, and they were comparable(P>0.05). The detection rates of CCA-IMT thickening in the left and right sides of control group and trial group were 39.06%, 32.81% and 60.96%, 46.58%, respectively. The detection rate of trial group was higher than that of the control group, the difference was statistically significant(P<0.05). Hypertension was associated with CCA-IMT, with the longer hypertension duration, the rate of the CCA-IMT increased(χ2=9.304,P<0.05). Hypertension was associated with the carotid plaques, with the longer hypertension duration, the detection rate of the carotid plaques increased(χ2=10.344,P<0.05). Conclusion Clinical need to strengthen screening and prevention and treatment of stroke, especially for high-risk stroke associated with hypertension crowd, and actively take effective preventive and therapeutic measures will reduce the incidence of stroke.
  [Key words] Hypertension; Carotid atherosclerosis; Influence and pathogenesis
  腦卒中作為一種急性腦血管疾病,包括缺血性腦卒中和出血性腦卒中。其中前者的發(fā)病率要明顯高于后者。頸內(nèi)動(dòng)脈、椎動(dòng)脈閉塞和狹窄會(huì)引發(fā)缺血性腦卒中,主要發(fā)生在40多歲以上的男性患者。相關(guān)研究發(fā)現(xiàn),清晨高血壓是卒中事件最強(qiáng)的獨(dú)立預(yù)測(cè)因素,缺血性卒中在清晨時(shí)段發(fā)生的風(fēng)險(xiǎn)是其他時(shí)段的4倍[1],清晨血壓每升高10 mmHg,卒中風(fēng)險(xiǎn)增加44%[2]。而頸內(nèi)動(dòng)脈或椎動(dòng)脈狹窄和閉塞的主要原因就是動(dòng)脈粥樣硬化。越來越多研究證實(shí),高血壓是中國(guó)人群卒中發(fā)病的最重要危險(xiǎn)因素[3]。介于此,該文對(duì)2011年1月—2015年12月該院收治的210例腦卒中高危人群進(jìn)行頸動(dòng)脈粥樣硬化的相關(guān)變化進(jìn)行研究,現(xiàn)具體報(bào)道如下。
  1 資料與方法
  1.1 一般資料

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