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目的探讨老年高血压脑梗死患者合并2型糖尿病与颈动脉粥样硬化的变化及与复发性脑梗死的关系。方法彩色多普勒超声对170例老年高血压脑梗死患者的颈动脉进行检测。结果142例患者颈动脉有不同程度的粥样斑块形成。与高血压非糖尿病脑梗死组比较,高血压合并糖尿病组斑块以低回声软斑为主,其不稳定斑块的比例明显增高,P<0.01。高血压合并糖尿病脑梗死组的复发构成比较高血压非糖尿病组为高,P<0.01。结论糖尿病和高血压同时存在对颈动脉粥样硬化的发展有更大危害。彩色多普勒超声是检测颈动脉粥样斑块性质的有效方法,对合并2型糖尿病的老年高血压脑梗死患者常规定期监测,发现不稳定斑块(软斑和混合斑)积极治疗,预防复发。
Objective To investigate the relationship between type 2 diabetes mellitus and carotid atherosclerosis in elderly patients with hypertensive cerebral infarction and its relationship with recurrent cerebral infarction. Methods Color Doppler ultrasound was used to detect carotid artery in 170 elderly patients with hypertensive cerebral infarction. Results The carotid arteries of 142 patients had different degrees of plaque formation. Compared with hypertensive non-diabetic cerebral infarction group, hypoechoic plaque was predominant in hypertensive patients with diabetes mellitus, and the proportion of unstable plaques was significantly increased, P <0.01. Hypertensive patients with diabetes mellitus had a higher incidence of recurrent hypertension than non-diabetic patients (P <0.01). Conclusion The simultaneous presence of diabetes mellitus and hypertension is more harmful to the development of carotid atherosclerosis. Color Doppler ultrasonography is an effective method to detect the nature of carotid atherosclerotic plaque. Regular monitoring of elderly patients with type 2 diabetes mellitus with cerebral infarction showed that unstable plaques (soft plaque and mixed plaques) were actively treated and prevented relapse.