彩色多普勒超声检查评估老年退行性心脏瓣膜病与颈动脉粥样硬化的相关性研究

目的:应用彩色多普勒超声评估老年退行性心脏瓣膜病(SDHVD)与颈动脉粥样硬化相关性。方法:选择2016年5月-2018年7月中国医科大学航空总医院收治的老年SDHVD患者240例作为观察组,根据心瓣膜钙化程度分级标准将所有患者分为1级组61例、2级组84例以及3级组95例。另取同期于我院住院治疗的非SDHVD患者100例作为对照组。所有患者均接受彩色多普勒超声检查,比较观察组与对照组患者的基础疾病合并情况,对比不同组别患者颈动脉内膜中层厚度(IMT)、颈动脉斑块积分以及颈动脉管腔狭窄程度情况,分析SDHVD与颈动脉粥样硬化相关性。结果:观察组冠心病、糖尿病、高血压以及高脂血症发生率分别为47.08%、50.42%、93.75%、81.67%,均分别高于对照组的24.00%、29.00%、68.00%、52.00%(P0.05)。对照组、1级组、2级组、3级组的IMT以及颈动脉斑块积分比较存在统计学差异,且随着心瓣膜钙化程度分级的逐渐提高,IMT以及颈动脉斑块积分呈逐渐上升趋势(P0.05)。随着心瓣膜钙化程度分级的逐渐升高,颈动脉管腔狭窄程度在50%-70%以及71%-99%中的发生率呈逐渐升高趋势(P0.05)。经Pearson相关性分析显示:SDHVD严重程度与IMT、颈动脉斑块积分以及颈动脉管腔狭窄程度均呈正相关(P0.05)。结论:彩色多普勒超声检查可有效评估SDHVD与颈动脉粥样硬化的严重程度,且SDHVD患者多并发基础疾病,临床应积极预防。

A Study of Correlation between Degenerative Heart Valvular Disease and Carotid Atherosclerosis by Color Doppler Ultrasonography in Elderly

ABSTRACT Objective: To evaluate the correlation between degenerative valvular heart disease (SDHVD) and carotid atherosclerosis by color doppler ultrasonography in elderly. Methods: 240 elderly patients with SDHVD who were treated in Aviation General Hospital of China Medical University from May 2016 to July 2018 were selected as the observation group. All patients were divided into 1-grade group (61 cases), 2-grade group (84 cases) and 3-grade group (95 cases) according to the classification standard of cardiac valve calcification. Another 100 non-SDHVD patients who were hospitalized in our hospital during the same period were selected as the control group. All patients were examined by color doppler ultrasonography, the basic diseases in the observation group and the control group were compared, the carotid intima-media thickness (IMT), carotid plaque score and carotid lumen stenosis in different groups were compared. The correlation between SDHVD and carotid atherosclerosis was analyzed. Results: The incidence of coronary heart disease, diabetes mellitus, hypertension and hyperlipidemia in the observation group were 47.08%, 50.42%, 93.75% and 81.67% respectively, which were higher than those in the control group (24.00%, 29.00%, 68.00%, 52.00%) (P<0.05). There were statistically significant differences in IMT and plaque score among the control group, the 1-grade group, the 2-grade group and the 3-grade group. And with the gradual improvement of cardiac valve calcification grade, IMT and plaque score increased gradually (P<0.05). With the gradual increase of heart valve calcification grade, the incidence of stenosis of carotid artery in 50%-70% and 71%-99% increased gradually (P<0.05). Pearson correlation analysis showed that SDHVD severity was positively correlated with IMT, carotid plaque score and carotid lumen stenosis (P<0.05). Conclusion: Color doppler ultrasonography can effectively assess the severity of SDHVD and carotid atherosclerosis, and SDHVD patients often suffer from underlying diseases, which should be actively prevented.