老年人无症状颈动脉粥样硬化斑块的预后分析
刘勇华,顾金伟,苗乐静
摘要(Abstract)：
目的探讨老年人无症状性颈动脉粥样硬化斑块的预后。方法选取年龄>60岁的老年患者228例进行颈动脉超声检查和血小板聚集试验,根据斑块形态分成无病变组、结节性斑块组、附壁斑块组。血小板聚集能力评估分为抑制、正常或加速。结果平均随访4a,死亡31例,其中16例死于血管事件(脑梗死或缺血性心脏疾病)。Kaplan-Meier生存曲线显示附壁斑块组预后差。结论有附壁斑块和血小板聚集能力加速的受试者其血管事件的预后较差,抗血小板治疗和运动负荷试验检测冠心病应考虑以上因素。
关键词(KeyWords)： 超声波;血小板功能;脑梗死;缺血性心脏病;病死率
基金项目(Foundation):
作者(Author): 刘勇华,顾金伟,苗乐静
参考文献(References)：
- [1]Hennerici M,Hulsbomer HB,Hefter H,et al.Natural history of asymptomatic extracranial arterial disease[J].Brain,1987,110(3):777-791.
- [2]O'Holleran LW,Kennelly M,McClurken M,et al.Natural historyof asymptomatic carotid plaque[J].Five year follow-up study,1987,154(7):659-662.
- [3]Mase K,Yanagihara F,Asada T,et al.Evaluation of platelet aggregation test by grading curve[J].Jpn J ClinPatho,1992,140(9):857-862.
- [4]Espeland MA,Hoen H,Byington R,et al.Spatial distribution of carotid intimal-medial thickness as measured byB-mode ultrasonography[J].Stroke,1994,25(4):1 812-1 819.
- [5]Belcaro G,Nicolaides AN,Laurora G,et al.Ultrasound morphology classification of the arterial wall and cardiovascular events in a 6-year followup study[J].Arterioscler Thromb Vase Biol,1996,16(1):851-856.
- [6]Kagawa R,Moritake K,Shima T,et al.Validity ofB-mode ultrasonographicfindings in patients undergoing carotid endarterectomy in comparisonwith angiographic and clinicopathologic features[J].Stroke,1996,27(3):700-705.