经颅多普勒超声评估老年颅内外动脉狭窄及相关因素分析  

Assessment of intracranial and extracraninl artery stenosis and its risk factors in elderly patients by transcranial Doppler ultrasonography

作　　者：方俐[1] 李晓裔[1] 邵西仓[1] 刘姝[1] 李想[1] 吴云[1] 张代君[1] 张弘弛[1] 左婉一 

机构地区：[1]贵州省人民医院神经电生理中心,贵阳550002

出　　处：《中华老年心脑血管病杂志》2015年第9期922-924,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的利用经颅多普勒超声（TCD）评估老年颅内外动脉狭窄的相关危险因素。方法选择TCD筛查、并经其他影像检查确诊的颅内外动脉狭窄患者299例,分为老年组（≥60岁）200例和非老年组（40～59岁）99例,记录血管疾病相关病史,分析各危险因素的影响特点。结果老年组前循环狭窄发生率低于非老年组（66.5%vs82.8%,P=0.002）,前后循环狭窄发生率高于非老年组（14.0%vs 4.0%,P=0.005）,颅内外动脉狭窄发生率高于非老年组（9.0%vs 3.0%,P=0.043）。老年组与非老年组大脑中动脉狭窄发生率比较无显著差异（74.0%vs72.7%,P=0.459）。高血压、糖尿病、高脂血症、吸烟、心脑血管危险因素家族史是老年颅内外动脉狭窄的独立危险因素（P=0.000）。结论老年颅内外动脉和前后循环狭窄发生率明显增高,存在长期吸烟、高血压、糖尿病、高脂血症及有心脑血管病危险因素家族史等患者应常规进行TCD检测。Objective To assess the intracranial and extracranial artery stenosis and its risk factors in elderly patients by TCD ultrasonography. Methods Two hundred and ninety-nine patients with TCD ultrasonography-confirmed intracranial and extracranial artery stenosis were divided in- to ≥60 years old group （nz200） and 40--59 years old group （n=99）. The risk factors for vascu- lar diseases were compared between the two groups. Results The incidence of anterior circulation stenosis was significantly lower while that of anterior-posterior circulation stenosis was signifi- cantly higher in ≥60 years old group than in 40--59 years old group （66.5% vs 82.8% ;14.0% vs 4.0% ,P〈0.01）. The incidence of intracranial and extracranial artery stenosis was significantly higher in ≥60 years old group than in 40--59 years old group （9.0% vs 3.0%,P=0. 043）. No significant difference was found in the incidence of MCA stenosis between the two groups. That hypertension, diabetes, hyperlipemia, smoking and family history of cardio-cerebrovascular disease were the independent risk factors for intracranial artery stenosis in elderly patients. Conclusion The incidence of intracranial and extracranial artery stenosis and anterior-posterior circulation ste- nosis is significantly higher in elderly subjects than in non-elderly subjects. Conventional TCD ul- trasonography is necessary for those with a history of smoking, hypertension, diabetes, hyper- lipemia and a family history of cardio-cerebrovascular disease.

关 键 词：超声检查 多普勒 经颅 颅内动脉硬化 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]