老年人心肌梗死与颈动脉粥样硬化的相关性分析  

Correlation between myocardial infarction and carotid atherosclerosis in older adult patients

作　　者：张婧[1] 徐海飞[1] 李刚[1] Zhang Jing;Xu Haifei;Li Gang(Department of Ultrasound,Lishui People's Hospital,Lishui 323000,Zhejiang Province,China)

机构地区：[1]丽水市人民医院超声科,丽水323000

出　　处：《中国基层医药》2022年第11期1606-1610,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨老年人心肌梗死与颈动脉粥样硬化的相关性。方法选取2020年6月至2021年6月丽水市人民医院收治的老年心肌梗死患者98例为观察对象,根据病情程度将患者分为轻度(25例)、中度(43例)、重度(30例)3个亚组;另选取该院同期体检健康人群50例为对照组。均进行彩色多普勒超声检查,评估受检者颈动脉管腔狭窄程度及其与心肌梗死严重程度的相关性。结果心肌梗死组98例患者中,超声检出颈动脉斑块者88例,检出率为89.8%(88/98),共检出颈动脉斑块327个;对照组检出颈动脉斑块者17例,检出率为34.0%(17/50),共检出颈动脉斑块85个。心肌梗死组患者斑块性质以混合斑块、软斑块为主,占比分别为34.8%(114/327)、51.4%(168/327);对照组斑块性质以钙化斑块为主,占比62.3%(53/85),两组斑块性质比较,差异有统计学意义(χ^(2)=102.23,P<0.001)。对照组与心肌梗死组颈动脉管腔狭窄程度比较,差异有统计学意义(χ^(2)=60.07,P<0.05);且随着心肌梗死患者病情的加重,颈动脉管腔狭窄程度加重(χ^(2)=15.17,P<0.05)。重度组颈动脉内膜中层厚度(IMT)为(1.49±0.26)mm,均高于中度组的(1.28±0.24)mm、轻度组的(1.15±0.21)mm、对照组的(0.82±0.16)mm(t=5.21、7.42、14.29,均P<0.05);重度组颈动脉斑块积分(PS)为(2.56±0.51)分,均高于中度组的(2.33±0.45)分、轻度组的(1.58±0.39)分、对照组的(1.12±0.36)分(t=3.00、11.23、14.77,均P<0.05)。相关性分析显示,心肌梗死严重程度与颈动脉管腔狭窄程度及IMT、颈动脉斑块积分均呈正相关(r=0.41、0.33、0.28,均P<0.01)。结论老年人心肌梗死严重程度与颈动脉粥样硬化存在相关性,可将颈动脉管腔狭窄程度作为心肌梗死严重程度的预测指标。Objective To investigate the correlation between myocardial infarction and carotid atherosclerosis in older adult patients.Methods A total of 98 older adult patients with myocardial infarction who received treatment in Lishui People's Hospital from June 2020 to June 2021 were included in this study.They were divided into three subgroups:mild(n=25),moderate(n=43)and severe(n=30)groups according to the severity of myocardial infarction.An additional 50 healthy subjects who concurrently received physical examination in the same hospital were included as controls.All participants underwent color Doppler ultrasound to evaluate the degree of carotid stenosis and its correlation with the severity of myocardial infarction.Results In the myocardial infarction group,327 carotid plaques were detected in 88 out of 98 patients,with the detection rate of 89.8%.In the control group,85 carotid plaques were detected in 17 out of 50 healthy subjects,with the detection rate of 34.0%.In the myocardial infarction group,most plaques were mixed and soft,accounting for 34.8%(114/327)and 51.4%(168/327),respectively.In the control group,most plaques were calcified,accounting for 62.3%(53/85).There was significant difference in plaque property between the two groups(χ^(2)=102.23,P<0.05).There was significant difference in the degree of carotid lumen stenosis between control and myocardial infarction groups(χ^(2)=60.07,P<0.05).The degree of carotid lumen stenosis increased with the aggravation of myocardial infarction(χ^(2)=15.17,P<0.05).Carotid intima-media thickness in the severe group was(1.49±0.26)mm,which was significantly greater than(1.28±0.24)mm in the moderate group,(1.15±0.21)mm in the mild group and(0.82±0.16)mm in the control group(t=5.21,7.42,14.29,all P<0.05).Plaque score in the severe group was(2.56±0.51)points,which was significantly higher than(2.33±0.45)points in the moderate group,(1.58±0.39)points in the mild group,and(1.12±0.36)points in the control group(t=3.00,11.23,14.77,all P<0.05).Correlation analysis sh

关 键 词：心肌梗死 动脉粥样硬化 颈动脉 超声检查 多普勒 彩色 老年人 

分 类 号：R542.22[医药卫生—心血管疾病] R543.4[医药卫生—内科学]