Chinese General Practice ›› 2018, Vol. 21 ›› Issue (17): 2111-2115.DOI: 10.3969/j.issn.1007-9572.2018.00.097

Special Issue: 高血压最新文章合集

• Monographic Research • Previous Articles     Next Articles

Mechanical Analysis of Carotid Artery Vulnerable Plaque in Patients with Hypertension Complicated with Cerebral Infarction　

  

  1. Department of Ultrasound，North China University of Science and Technology Affiliated Hospital，Tangshan 063000，China
    *Corresponding author：KAN Yan-min，Associate chief physician，Master supervisor；E-mail：wuxiny_2009@163.com
  • Published:2018-06-15 Online:2018-06-15

高血压伴脑梗死患者颈动脉易损斑块的力学分析研究

  

  1. 063000河北省唐山市，华北理工大学附属医院超声科
    *通信作者：阚艳敏，副主任医师，硕士生导师；E-mail：wuxiny_2009@163.com

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Abstract: Objective　To observe the predilection site and acoustic characteristics of carotid artery vulnerable plaques in hypertension complicated with cerebral infarction patients and to explore the value of velocity vector imaging（VVI） technology to detect the stress and strain of plaques.Methods　98 patients in hypertension complicated with carotid artery atherosclerotic plaques with cerebral infarction（as case group） and 70 patients in hypertension associated with carotid artery atherosclerotic plaques（as control group） were chosen from May 2016 to June 2017 in North China University of Science and Technology Affiliated Hospital.The location of the vulnerable plaques were observed by two-dimensional ultrasound，and the main mechanical parameters of carotid arterial wall and plaques including velocity，strain and strain rate were detected by VVI technology.Results　There were 88 cases（52.4%） of carotid bifurcation plaques of patients of two groups，mainly to vulnerable plaques.And the incidence of vulnerable plaques of the common carotid artery was 17.8%（30/168），and the extracranial segment of internal carotid artery was 29.8%（50/168）．In the case group，50 cases（51.0%） had hypoechoic plaques，48 cases（49.0%） had heterogeneous plaques.And in the control group，38 cases（54.3%） had hypoechoic plaques，32 cases（45.7%） had heterogeneous plaques.There were no significant difference in the distributions of the hypoechoic plaques and the heterogeneous plaques between two groups（P>0.05）．The velocity，plaque strain and strain rate in the proximal intimal surface，proximal shoulder，the top of plaques，distal shoulder and distal intimal surface of the hypoechoic plaques and the heterogeneous plaques in case group were higher than those in control group（P<0.05）．Conclusion　The stability of carotid artery vulnerable plaques in hypertension complicated with cerebral infarction patients is worse than that in patients with hypertension，and the mechanical changes of carotid arterial plaques by VVI technology can provide an objective basis for early prevention and treatment of hypertension and for reducing recurrence rate of cerebral infarction.

 

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摘要：

目的　通过二维超声观察高血压伴脑梗死患者颈动脉易损斑块的好发部位和声学特征，探讨速度向量成像（VVI）技术检测斑块受力及应变情况的价值。方法　选取2016年5月—2017年6月华北理工大学附属医院接诊的伴有动脉粥样硬化斑块形成的高血压伴脑梗死患者98例为病例组，同期因健康查体就诊的伴有动脉粥样硬化斑块形成的高血压患者70例为对照组。运用二维超声观察易损斑块的发生部位，采用VVI技术获取动脉管壁及斑块局部组织的主要指标，包括运动速度、应变力、应变率等。结果　两组患者中颈动脉分叉处斑块发生率为52.4%（88/168），以易损斑块为主；颈总动脉斑块发生率为17.8%（30/168）；颈内动脉颅外段斑块发生率为29.8%（50/168）。病例组低回声斑块50例（51.0%），混合回声斑块48例（49.0%）；对照组低回声斑块38例（54.3%），混合回声斑块32例（45.7%）。两组低回声斑块、混合回声斑块分布比较，差异均无统计学意义（P>0.05）。病例组近心端内膜面、近心端肩部、斑块顶端、远心端肩部、远心端内膜面的低回声斑块、混合回声斑块的运动速度、应变力、应变率均高于对照组（P<0.05）。结论　高血压伴脑梗死患者颈动脉易损斑块稳定性较高血压患者差，应用VVI技术可监测动脉斑块的力学变化，为临床及早防治高血压、降低脑梗死复发率提供客观依据。

关键词: 高血压, 脑梗死, 斑块, 动脉粥样硬化, 易损斑块, 颈动脉

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