高频超声探测血管性痴呆患者颈动脉的初步研究
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摘要
目的:探讨血管性痴呆患者检测颈动脉粥样硬化的临床意义。
方法:经临床确诊的血管性痴呆患者30例,对照组30例。利用高频超声探测颈动脉内-中膜厚度(IMT)及粥样硬化斑块形成情况。
结果:血管性痴呆组的IMT增厚、粥样硬化斑块发生率明显高于对照组(P<0.05);血管性痴呆组中软斑检出率高于硬斑及混合斑(P<0.05)。
结论:血管性痴呆组患者的IMT及粥样硬化斑块形成率明显高于对照组,血管性痴呆组检出斑块中软斑占优势。高频超声是检测血管性痴呆患者颈动脉粥样硬化的简便而有效的方法,具有重要的临床价值。
Objective : To investigate the clinical significance of high-frequency ultrasound evaluation of vascular dementia in elderly patients with carotid atherosclerosis.
Methods:30 cases of vascular dementia were assigned to vascular dementia group and 30 healths were chosen as controls which match the vascular dementia group in human basic data. The high-frequency ultrasound was used to detect the intima-media thickness (IMT) and the atherosclerotic plaque formed within the carotid.
Results:The incidence of carotid atherosclerosis and its plaque formation in vascular dementia group were significantly higher than those in control group.Compared with the control group, the IMT was thicker, the plaque formation was much more in vascular dementia group (P<0.05) and the character of the plaque was mainly soft in the group of vascular dementia, in other words, less were hard plaques and mixed plaques(P<0.05).
Conclusion:The atherosclerotic plaque formation rate in patients with vascular dementia was significantly higher than that in the control group.High-frequency ultrasound is a simple and effective method in detecting carotid atherosclerosis, of which has important clinical value.
方法:经临床确诊的血管性痴呆患者30例,对照组30例。利用高频超声探测颈动脉内-中膜厚度(IMT)及粥样硬化斑块形成情况。
结果:血管性痴呆组的IMT增厚、粥样硬化斑块发生率明显高于对照组(P<0.05);血管性痴呆组中软斑检出率高于硬斑及混合斑(P<0.05)。
结论:血管性痴呆组患者的IMT及粥样硬化斑块形成率明显高于对照组,血管性痴呆组检出斑块中软斑占优势。高频超声是检测血管性痴呆患者颈动脉粥样硬化的简便而有效的方法,具有重要的临床价值。
Objective : To investigate the clinical significance of high-frequency ultrasound evaluation of vascular dementia in elderly patients with carotid atherosclerosis.
Methods:30 cases of vascular dementia were assigned to vascular dementia group and 30 healths were chosen as controls which match the vascular dementia group in human basic data. The high-frequency ultrasound was used to detect the intima-media thickness (IMT) and the atherosclerotic plaque formed within the carotid.
Results:The incidence of carotid atherosclerosis and its plaque formation in vascular dementia group were significantly higher than those in control group.Compared with the control group, the IMT was thicker, the plaque formation was much more in vascular dementia group (P<0.05) and the character of the plaque was mainly soft in the group of vascular dementia, in other words, less were hard plaques and mixed plaques(P<0.05).
Conclusion:The atherosclerotic plaque formation rate in patients with vascular dementia was significantly higher than that in the control group.High-frequency ultrasound is a simple and effective method in detecting carotid atherosclerosis, of which has important clinical value.
引文
[1]蒙泽明,吴荣辉.脑卒中患者发生血管性痴呆危险因素探讨.2008,24(13)4-7
[2] Pignoli P,Tremoli E,Poli A,et a1.Intimal plus medial thickness of the arterial wall:a direct measurement with ultrasound imaging[J].Circulation.1986,74(6):1399-1406.
[3] Srinivasan J,Mayberg MR,Weiss DG,et a1.Duplex accuracy compared with angiography in the Veterans Affairs CooperativeStudiesal for Symptomatic CarotidStenosis [J].Neun'surgery.1995,36(4).,648-653.
[4] Patel MR,Kuntz KM.Klufas RA,et a1.Preoperative assessment of the carotid bifurcation.Can magnetic i'egoce angiography and duplex ultrasonography replace contrast arteriography[J].Stroke,1995,26(1).1753-17586.
[5]胡庆鹰,崔炜,吴格日勒,何彬.彩色多普勒超声检查颈动脉内膜一中层厚度的研究进展[J],中国当代医药,2009,16(15),40-42
[6]范肖冬,汪向东,于欣,刘平译.ICD-10精神与行为障碍分类.人民卫生出版社.1993.44.
[7]任卫东,唐力.血管超声诊断基础与临床.人民军医出版社.2006.87.
[8] Chambers BR,Donnan GA.Carotid endarterectomy for asymptomatic carotid ste- nosis.Cochrance Database Syst Rev,2005,19(4):CD001923.
[9]董艳玲.颈动脉粥样硬化与缺血性脑卒中[J].脑与神经疾病杂志,2003,11(2):127-128.
[10] Wikstand J,Wiklund O.Frontiers in cardiovascular science.Quantitative measure-ments of atherosclerotic manifestations in human[J].Artefioscler Thromb,1992,12(1):114- 119.
[11] Touboul P J,Elbaz A,Koller C,et a1.Common carotid artery intimar-media thickness and brain infarction:the Etude du Profil Genetique de I Infarctus Cerebral(GENIe case control study.The GENIC Investigators[J].Circulation,2000,102(3):313-318.
[12]王海燕,王娟.声学密度定量分析颈动脉粥样硬化的初步研究[J].中国超声医学杂志,2003,2(19):93.
[13]包静,李振东.颈动脉粥样硬化斑块及其危险因素与脑梗死的关系陕西医学杂志,2008,37(12):1629-1631
[14]钱建林,宣丽敏,周卫华.彩色多普勒超声对脑梗死患者颈动脉粥样硬化斑块特点的观察中国超声诊断杂志,2006,7(1):41
[15]吴升,徐爱芬,骆建军.彩色多普勒超声在老年脑梗死病中的临床应用[J].同济医科大学学报,2000,29:84.85.
[16]贾伟华,田桂玲.颈动脉斑块稳定性的研究进展.国外医学脑血管疾病分册.2004,12(2):145.
[17]何育生,王星,陈辉新,等.脑梗死后痴呆的临床分析[J].中风与神经疾病杂志,2001,18(4):226-228
[1] Hachinski V, Iadecola C, Petersen RC, et al. NINDS-CSN vascular cognitive impairment harmonization standard. Stroke, 2006;37:2220-2241.2.Chui HC, Nielsen-Brown N. Vascular cognitive impairment. Continuum Lifelong Learning Neurol, 2007;13:109?143.
[2] Prins ND.Hicks MS.Hogan DB.et al.Supplemental use of antioxidant vitamins and subsequent risk of cogmitive decline and dementia[J].Dement Geriatr Cogn Disord. 2005,20:45-51
[3] Bastos-Leite AJ,van der Flier WM,van Straaten EC,et al.The contribution of medial temporal lobe atrophy and vascular pathology to cognitivr impairment in vascular demenntia[J].Stroke,2007,38:3182-3185
[4]血管性认知功能损害专家组。血管性认知功能损害的专家共识。中华内科学杂志,2007,46(12):1052-1055
[5] Falcone C.Emanuele E.D'Angeio A Plasma levels of soluble receptor for advanced glycation end products and coronary artery disease in nondiabetic men 2005
[6] Emanuele E.D'Angelo A.Tomaino C Circulating levels of soluble receptor for advanced glycation end products in Alzheimer disease and vascular dementia 2005
[7] MirandaPJ.DeFronzoRA.CaliffR MMetabolic syndrome:definition,pathophysiology,and mechanisms 2005
[8] Kwon HM.Kim BJ.Lee SH Metabolic syndrome as an independent risk factor of silent brain infarction in healthy people 2006
[9] van Oijen M.van der Meer IM.Hofman A Lipoproteinassociated phospholipase A2 is associated with risk of dementia 2006 .
[10]韩彦青,梅元武,李光来。血管性轻度认知障碍及非痴呆性血管性认知障碍患者局部脑血流量的临床研究。山西医科大学学报,2009,40(3):271-273
[11] American Psychiatric Association. Diagnostic and statistical manual of mental disorders.Washington,DC:American Psychiatric Association,1994
[12] World Health Organization. International statistical classification of diseases. Geneva: World Health Organization,1993
[13] Roman GC. Vascular dementia:diagnostic criteria for research studies.Report of the NINDS-AIREN International Workshop.Neurology,1993
[14] Chui HC. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers.Neurology,1992
[15] Ingles JL, Wentzel C, Fisk JD, et al.Neuropsychological predictors of incident dementia in patients with vascular cognitive impairment, without dementia. Stroke,2002; 33: 1999-2002.
[16] Erkinjutti T. Subcortical vascular dementia. Cerebrovasc Dis, 2002; 13(suppl12): 58-60.
[17] Pohjasvaara T, M?ntyl? R, Ylikoski R, et al. Clinical features of MRI-defined subcortical vascular disease. Alzheimer Dis Assoc Disord,2003;17:236?242.
[18] Erkinjutti T, Inzitari D, Pantoni L, et al. Research criteria for subcortical vascular dementia in clinical trials. J Neural Transm, 2002;59(suppl): 23-30.
[19] O'Brien JT.Erkinjuntti T.Reisberg B Vascular cognitive impairment 2003
[20] Tomimoto H.Ohtani R.Shibata M Loss of cholinergic pathways in vascular dementia of the Binswanger type 2005
[21] Rocca WA.Bower JH.Maraganore DM Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopanse 2007
[2] Pignoli P,Tremoli E,Poli A,et a1.Intimal plus medial thickness of the arterial wall:a direct measurement with ultrasound imaging[J].Circulation.1986,74(6):1399-1406.
[3] Srinivasan J,Mayberg MR,Weiss DG,et a1.Duplex accuracy compared with angiography in the Veterans Affairs CooperativeStudiesal for Symptomatic CarotidStenosis [J].Neun'surgery.1995,36(4).,648-653.
[4] Patel MR,Kuntz KM.Klufas RA,et a1.Preoperative assessment of the carotid bifurcation.Can magnetic i'egoce angiography and duplex ultrasonography replace contrast arteriography[J].Stroke,1995,26(1).1753-17586.
[5]胡庆鹰,崔炜,吴格日勒,何彬.彩色多普勒超声检查颈动脉内膜一中层厚度的研究进展[J],中国当代医药,2009,16(15),40-42
[6]范肖冬,汪向东,于欣,刘平译.ICD-10精神与行为障碍分类.人民卫生出版社.1993.44.
[7]任卫东,唐力.血管超声诊断基础与临床.人民军医出版社.2006.87.
[8] Chambers BR,Donnan GA.Carotid endarterectomy for asymptomatic carotid ste- nosis.Cochrance Database Syst Rev,2005,19(4):CD001923.
[9]董艳玲.颈动脉粥样硬化与缺血性脑卒中[J].脑与神经疾病杂志,2003,11(2):127-128.
[10] Wikstand J,Wiklund O.Frontiers in cardiovascular science.Quantitative measure-ments of atherosclerotic manifestations in human[J].Artefioscler Thromb,1992,12(1):114- 119.
[11] Touboul P J,Elbaz A,Koller C,et a1.Common carotid artery intimar-media thickness and brain infarction:the Etude du Profil Genetique de I Infarctus Cerebral(GENIe case control study.The GENIC Investigators[J].Circulation,2000,102(3):313-318.
[12]王海燕,王娟.声学密度定量分析颈动脉粥样硬化的初步研究[J].中国超声医学杂志,2003,2(19):93.
[13]包静,李振东.颈动脉粥样硬化斑块及其危险因素与脑梗死的关系陕西医学杂志,2008,37(12):1629-1631
[14]钱建林,宣丽敏,周卫华.彩色多普勒超声对脑梗死患者颈动脉粥样硬化斑块特点的观察中国超声诊断杂志,2006,7(1):41
[15]吴升,徐爱芬,骆建军.彩色多普勒超声在老年脑梗死病中的临床应用[J].同济医科大学学报,2000,29:84.85.
[16]贾伟华,田桂玲.颈动脉斑块稳定性的研究进展.国外医学脑血管疾病分册.2004,12(2):145.
[17]何育生,王星,陈辉新,等.脑梗死后痴呆的临床分析[J].中风与神经疾病杂志,2001,18(4):226-228
[1] Hachinski V, Iadecola C, Petersen RC, et al. NINDS-CSN vascular cognitive impairment harmonization standard. Stroke, 2006;37:2220-2241.2.Chui HC, Nielsen-Brown N. Vascular cognitive impairment. Continuum Lifelong Learning Neurol, 2007;13:109?143.
[2] Prins ND.Hicks MS.Hogan DB.et al.Supplemental use of antioxidant vitamins and subsequent risk of cogmitive decline and dementia[J].Dement Geriatr Cogn Disord. 2005,20:45-51
[3] Bastos-Leite AJ,van der Flier WM,van Straaten EC,et al.The contribution of medial temporal lobe atrophy and vascular pathology to cognitivr impairment in vascular demenntia[J].Stroke,2007,38:3182-3185
[4]血管性认知功能损害专家组。血管性认知功能损害的专家共识。中华内科学杂志,2007,46(12):1052-1055
[5] Falcone C.Emanuele E.D'Angeio A Plasma levels of soluble receptor for advanced glycation end products and coronary artery disease in nondiabetic men 2005
[6] Emanuele E.D'Angelo A.Tomaino C Circulating levels of soluble receptor for advanced glycation end products in Alzheimer disease and vascular dementia 2005
[7] MirandaPJ.DeFronzoRA.CaliffR MMetabolic syndrome:definition,pathophysiology,and mechanisms 2005
[8] Kwon HM.Kim BJ.Lee SH Metabolic syndrome as an independent risk factor of silent brain infarction in healthy people 2006
[9] van Oijen M.van der Meer IM.Hofman A Lipoproteinassociated phospholipase A2 is associated with risk of dementia 2006 .
[10]韩彦青,梅元武,李光来。血管性轻度认知障碍及非痴呆性血管性认知障碍患者局部脑血流量的临床研究。山西医科大学学报,2009,40(3):271-273
[11] American Psychiatric Association. Diagnostic and statistical manual of mental disorders.Washington,DC:American Psychiatric Association,1994
[12] World Health Organization. International statistical classification of diseases. Geneva: World Health Organization,1993
[13] Roman GC. Vascular dementia:diagnostic criteria for research studies.Report of the NINDS-AIREN International Workshop.Neurology,1993
[14] Chui HC. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers.Neurology,1992
[15] Ingles JL, Wentzel C, Fisk JD, et al.Neuropsychological predictors of incident dementia in patients with vascular cognitive impairment, without dementia. Stroke,2002; 33: 1999-2002.
[16] Erkinjutti T. Subcortical vascular dementia. Cerebrovasc Dis, 2002; 13(suppl12): 58-60.
[17] Pohjasvaara T, M?ntyl? R, Ylikoski R, et al. Clinical features of MRI-defined subcortical vascular disease. Alzheimer Dis Assoc Disord,2003;17:236?242.
[18] Erkinjutti T, Inzitari D, Pantoni L, et al. Research criteria for subcortical vascular dementia in clinical trials. J Neural Transm, 2002;59(suppl): 23-30.
[19] O'Brien JT.Erkinjuntti T.Reisberg B Vascular cognitive impairment 2003
[20] Tomimoto H.Ohtani R.Shibata M Loss of cholinergic pathways in vascular dementia of the Binswanger type 2005
[21] Rocca WA.Bower JH.Maraganore DM Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopanse 2007