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目的:探讨老年人颈动脉粥样硬化临床特点及其相关危险因素。方法:收集符合纳入标准的住院老年患者临床资料,颈动脉多普勒检测颈总动脉内中膜厚度(IMT)、斑块有无及性质、管腔狭窄程度。结果:(1)老年人群颈总动脉IMT异常者占50.53%;颈动脉斑块阳性者占78.7%;颈动脉狭窄者占20%,以轻度狭窄为主。(2)颈动脉斑块好发部位依次是左颈总分叉、左颈总动脉、右颈总动脉、右颈总分叉、颈动脉窦、左颈内动脉、右颈内动脉、右颈外动脉、左颈外动脉。(3)颈动脉斑块阳性人群合并高血压心肌梗塞脑血管意外和心脑血管事件率增加。(4)颈动脉IMT异常组较IMT正常组年龄、收缩压、甘油三酯,合并脑血管事件和心脑血管事件明显增加,同时颈总动脉IMT增厚伴颈动脉斑块阳性率、管腔狭窄率及斑块累及部位增加。结论:老年患者颈动脉粥样硬化的发病率高,斑块好发于颈动脉分叉、颈总动脉、颈内动脉,并以左侧常见。颈总动脉IMT异常组合并脑血管事件和心脑血管事件率明显增加,颈总动脉IMT增厚增加颈动脉斑块和管腔狭窄的发生率。
Objective: To investigate the clinical features and related risk factors of carotid atherosclerosis in the elderly. Methods: The clinical data of hospitalized elderly patients who met the inclusion criteria were collected. The carotid artery Doppler was used to detect the carotid artery intima - media thickness (IMT), the presence or absence of plaque and the degree of stenosis. Results: (1) The common carotid artery IMT in the elderly population accounted for 50.53%; the carotid artery plaque positive was 78.7%; the carotid artery stenosis was 20%, with mild stenosis. (2) The predilection sites of carotid plaques were left common carotid artery, left common carotid artery, right common carotid artery, right common carotid bifurcation, carotid sinus, left internal carotid artery, right internal carotid artery, right neck External artery, left external carotid artery. (3) The positive rate of cerebrovascular accident and cardiovascular events in patients with positive carotid plaque combined with hypertensive myocardial infarction increased. (4) The abnormal IMT in carotid artery group was significantly higher than that in normal IMT group in terms of age, systolic blood pressure, triglyceride, cerebrovascular events and cardiovascular and cerebrovascular events. The carotid IMT thickened with carotid plaque positive rate, Stenosis and plaque involvement increased. Conclusion: The incidence of carotid atherosclerosis in elderly patients is high, plaques occur in the bifurcation of the carotid artery, common carotid artery, internal carotid artery, and to the left common. The abnormal combination of carotid artery IMT and cerebrovascular events and cardiovascular events increased significantly, common carotid artery IMT thickening increased carotid artery plaque and stenosis incidence.