256层CT血管成像对老年H型高血压患者头颈部动脉狭窄的临床诊断价值  

Clinical value of 256-slice CT angiography in the diagnosis of head and neck artery stenosis in elderly patients with H-type hypertension

作　　者：左林 韩宇 崔光彬 姜小建[2] 赵佳[2] ZUO Lin;HAN Yu;CUI Guang-bin;JIANG Xiao-jian;ZHAO Jia(Radiology Department,Tangdu Hospital of Air Force Military Medical University,Xi'an 710038;Clinical Laboratory Department,Xi'an Central Hospital,Xi'an 710003,China)

机构地区：[1]空军军医大学唐都医院放射科,陕西西安,710038 [2]西安市中心医院检验科,陕西西安,710003

出　　处：《临床医学研究与实践》2019年第36期6-8,共3页Clinical Research and Practice

基　　金：西安市科技计划项目[No.201805102YX10SF36(6)]

摘　　要：目的分析H型高血压与头颈部动脉狭窄的相关性,并探讨256层CT血管成像(CTA)对老年H型高血压患者头颈部动脉狭窄的临床诊断价值。方法选取2017年6月至2019年1月西安市中心医院门诊或住院的高血压患者102例为研究对象。检测患者的血清同型半胱氨酸(Hcy)水平,对患者行头颈部CTA扫描。根据血清Hcy水平将患者分为H型高血压组(n=56)和非H型高血压组(n=46)。观察两组的CTA影像特征,比较两组头颈部动脉狭窄发生率、狭窄程度和动脉斑块性质。结果H型高血压组和非H型高血压组患者均可见轻度、中度及重度动脉狭窄,且在颈部动脉可以清晰地显示引起血管狭窄的斑块。H型高血压组动脉狭窄发生率为87.50%(49/56),显著高于非H型高血压组的43.48%(20/46),差异具有统计学意义(P<0.05)。H型高血压组的动脉中度及重度狭窄率均高于非H型高血压组,动脉轻度狭窄率低于非H型高血压组,差异具有统计学意义(P<0.05)。H型高血压组颈部动脉存在不稳定斑块的患者占比明显高于非H型高血压组,差异具有统计学意义(P<0.05)。结论H型高血压与头颈部动脉狭窄具有密切的相关性。256层CTA对老年H型高血压患者头颈部动脉狭窄的诊断具有重要的临床价值,可作为评估头颈部动脉狭窄的优选方法。Objective To analyze the correlation between H-type hypertension and head and neck artery stenosis,and to explore the clinical diagnostic value of 256-slice CT angiography(CTA)in the head and neck artery stenosis in elderly patients with H-type hypertension.Methods From June 2017 to January 2019,102 patients with hypertension in outpatient or inpatient of Xi’an central hospital were selected as the study objects.The level of serum homocysteine(Hcy)was detected and the head and neck CTA scan was performed.According to the level of serum Hcy,the patients were divided into H-type hypertension group(n=56)and non-H-type hypertension group(n=46).The CTA image features of the two groups were observed.The incidence rate and degree of head and neck artery stenosis and the stability of carotid plaque were compared between the two groups.Results Mild,moderate and severe arterial stenosis were observed in both the H-type hypertension group and the non-H-type hypertension group,and the plaque that causes vascular stenosis could be clearly displayed in cervical artery.The incidence of arterial stenosis was 87.50%(49/56)in the H-type hypertension group,which was significantly higher than 43.48%(20/46)in the non-H-type hypertension group,and there was a significant difference between the two groups(P<0.05).The moderate and severe stenosis rates of the H-type hypertension group were higher than those of the non-H-type hypertension group,and the mild stenosis rate of the Htype hypertension group was lower than that of the non-H-type hypertension group,and the differences were statistically significant(P<0.05).The proportion of patients with unstable plaque in cervical artery in the H-type hypertension group was significantly higher than that in the non-H-type hypertension group,and there was a significant difference between the two groups(P<0.05).Conclusion H-type hypertension is closely related to head and neck artery stenosis.256-slice CTA has important clinical value in the diagnosis of head and neck artery stenosis in elderl

关 键 词：CT血管成像 同型半胱氨酸 高血压 头颈部动脉狭窄 

分 类 号：R544.1[医药卫生—心血管疾病]