高血压对脑卒中高危人群颈动脉粥样硬化发生的影响及其病机探讨

　　[摘要] 目的 分析高血压对脑卒中高危人群颈动脉粥样硬化发生的影响及其病机。方法 方便选择2011年1月—2015年12月该院收治的210例脑卒中高危人群，根据有无高血压作为分组标准分为试验组146例和对照组64例，分析两组一般资料、CCA-IMT情况、颈动脉斑块检出情况以及病程与疾病进展的关系。结果 试验组与对照组在年龄、性别、吸烟史、体重指数方面差异无统计学意义（P>0.05），具有可比性。对照组和实验组左右侧CCA-IMT增厚检出率分别为39.06%、32.81%和60.96%、46.58%，试验组检出率明显高于对照组，差异有统计学意义（P<0.05）。高血压病程与CCA-IMT增厚存在相关性，病程增加，内膜增厚比例增加（χ2=9.304，P<0.05）。高血压病程与颈动脉斑块检出存在一定关系，随着高血压病程增加，颈动脉斑块检出率增加（χ2=10.344，P<0.05）。结论 临床需加强脑卒中的筛查防治工作，特别是针对伴有高血压的脑卒中高危人群，积极采取有效的预防与治疗措施，将降低脑卒中的发生。
　　[关键词] 高血压；颈动脉粥样硬化；影响与病机
　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）01（c）-0068-03
　　[Abstract] Objective This paper tries to analyze the effect of hypertension on carotid atherosclerosis and its pathogenesis. Methods 210 cases of high-risk of stroke in this deparment from January 2011 to December 2015 were selected， and divided into two groups by having hypertension or not， 146 cases in the trial group， and 64 cases in the control group. The relationship between the disease progression with the general information， CCA-IMT and the carotid plaques was analyzed. Results The difference in age， gender， smoking history and body mass index of the two groups were not significant. There was no statistical significance， and they were comparable（P>0.05）. The detection rates of CCA-IMT thickening in the left and right sides of control group and trial group were 39.06%， 32.81% and 60.96%， 46.58%， respectively. The detection rate of trial group was higher than that of the control group， the difference was statistically significant（P<0.05）. Hypertension was associated with CCA-IMT， with the longer hypertension duration， the rate of the CCA-IMT increased（χ2=9.304，P<0.05）. Hypertension was associated with the carotid plaques， with the longer hypertension duration， the detection rate of the carotid plaques increased（χ2=10.344，P<0.05）. Conclusion Clinical need to strengthen screening and prevention and treatment of stroke， especially for high-risk stroke associated with hypertension crowd， and actively take effective preventive and therapeutic measures will reduce the incidence of stroke.
　　[Key words] Hypertension； Carotid atherosclerosis； Influence and pathogenesis
　　腦卒中作为一种急性脑血管疾病，包括缺血性脑卒中和出血性脑卒中。其中前者的发病率要明显高于后者。颈内动脉、椎动脉闭塞和狭窄会引发缺血性脑卒中，主要发生在40多岁以上的男性患者。相关研究发现，清晨高血压是卒中事件最强的独立预测因素，缺血性卒中在清晨时段发生的风险是其他时段的4倍[1]，清晨血压每升高10 mmHg，卒中风险增加44%[2]。而颈内动脉或椎动脉狭窄和闭塞的主要原因就是动脉粥样硬化。越来越多研究证实，高血压是中国人群卒中发病的最重要危险因素[3]。介于此，该文对2011年1月—2015年12月该院收治的210例脑卒中高危人群进行颈动脉粥样硬化的相关变化进行研究，现具体报道如下。
　　1 资料与方法
　　1.1 一般资料

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