下肢动脉硬化闭塞症合并无症状性颈动脉狭窄229例  

Peripheral arterial occlusive disease complicating asymptomatic carotid stenosis

作　　者：张华[1] 潘仲杰[2] 赵奇[2] 栗力[2] 

机构地区：[1]天津市人民医院超声科,300121 [2]天津市人民医院血管外科,300121

出　　处：《中华普通外科杂志》2014年第8期607-609,共3页Chinese Journal of General Surgery

基　　金：天津市卫生局科技基金资助项目（2013KZ059）

摘　　要：目的 总结下肢动脉硬化闭塞症（peripheral arterial occlusive disease,PAOD）需血管重建术患者无症状重度颈动脉狭窄（asymptomatic carotid stenosis,ACS）发生率、临床特点及其相关危险因素,探讨PAOD术前行颈动脉超声筛查重度ACS的临床价值.方法 回顾性分析229例需血管重建术治疗的重度PAOD患者的临床资料,术前均行颈动脉超声检查筛查ACS,并将PAOD患者分为重度ACS组（ACS ≥70％）和非重度ACS组（ACS＜ 70％）,对2组患者临床特点及相关危险因素进行分析.结果 229例患者中,重度ACS发生率为19.7％;重度ACS组患者年龄、血压、总胆固醇和纤维蛋白原水平明显高于非重度ACS组,差异有统计学意义（P＜0.05）;PAOD症状越重的患者重度ACS的发生率越高;多因素Logistic回归分析显示高龄、高血压以及高胆固醇血症是重度ACS预测指标.结论 PAOD症状严重程度与重度ACS发生率呈正相关且高龄、高血压以及高胆固醇血症是重度ACS的独立危险因素.Objective To evaluate the incidence of asymptomatic carotid stenosis （ACS） in patients with peripheral arterial occlusive disease （PAOD） who was admitted for revascularization.Methods 229 PAOD patients were evaluated by carotid ultrasound preoperatively and divided into severe ACS group （ACS ≥ 70％） and non severe ACS group （ACS ＜ 70％）.The clinical characteristics and associated risk factors of the two groups were analyzed.Results The incidence of severe ACS was 19.7％,age,blood pressure,total cholesterol and fibrinogen levels in severe ACS group were significantly higher than those in non-severe ACS group （P ＜ 0.05）,the more severe the symptoms of PAOD are,the higher is the incidence of severe ACS.Age,hypertension and hypercholesterolemia were all predictors of severe ACS.Conclusions The severity of PAOD is positively correlated with the incidence of severe ACS.Age,hypertension and hypercholesterolemia are independent risk factors for severe ACS.

关 键 词：动脉闭塞性疾病 颈动脉狭窄 超声检查 多普勒 

分 类 号：R654.4[医药卫生—外科学]