CAJ | 학술논문

目的探讨老年患者常见血管危险因素与脑血管储备功能的相关性. 方法入选浙江医院2007年7月至2010年7月就诊的老年患者700例.收集其性别、年龄、吸烟史、饮酒史、高血压病史、糖尿病病史、高血脂病史、双侧颈动脉B超检查等一般资料.依据是否符合相关血管危险因素的诊断标准将患者分为血管危险因素组400例,年龄(73.4±6.8)岁；对照组300例,年龄(72.4±6.9)岁.其中性别不限,年龄≥60岁.同时对所有患者行经颅多普勒超声结合屏气试验来评估颅内血管反应,计算屏气指数,并对脑血管储备功能进行评价. 结果对照组屏气指数(BHI)为(0.97±0.31),脑血管危险因素组BHI为(0.57±0.18),两组比较差异有统计学意义(t=10.87,P＜0.01),表明有相关血管危险因素的老年患者脑血管储备功能较无血管危险因素的老年患者有一定程度的降低.多因素回归分析显示高血压、高脂血症、糖尿病以及吸烟是影响脑血管储备功能的主要因素,影响程度从大到小依次为糖尿病、高血压、吸烟、高脂血症. 结论具有血管危险因素可以损害老年患者脑血管储备力,其中高血压、高脂血症、糖尿病、吸烟是影响老年患者脑血管储备功能的主要因素,其中以糖尿病影响最大.
목적 탐토노년환자상견혈관위험인소여뇌혈관저비공능적상관성. 방법 입선절강의원2007년7월지2010년7월취진적노년환자700례.수집기성별、년령、흡연사、음주사、고혈압병사、당뇨병병사、고혈지병사、쌍측경동맥B초검사등일반자료.의거시부부합상관혈관위험인소적진단표준장환자분위혈관위험인소조400례,년령(73.4±6.8)세；대조조300례,년령(72.4±6.9)세.기중성별불한,년령≥60세.동시대소유환자행경로다보륵초성결합병기시험래평고로내혈관반응,계산병기지수,병대뇌혈관저비공능진행평개. 결과 대조조병기지수(BHI)위(0.97±0.31),뇌혈관위험인소조BHI위(0.57±0.18),량조비교차이유통계학의의(t=10.87,P＜0.01),표명유상관혈관위험인소적노년환자뇌혈관저비공능교무혈관위험인소적노년환자유일정정도적강저.다인소회귀분석현시고혈압、고지혈증、당뇨병이급흡연시영향뇌혈관저비공능적주요인소,영향정도종대도소의차위당뇨병、고혈압、흡연、고지혈증. 결론 구유혈관위험인소가이손해노년환자뇌혈관저비력,기중고혈압、고지혈증、당뇨병、흡연시영향노년환자뇌혈관저비공능적주요인소,기중이당뇨병영향최대.
Objective To explore the relationship between the common vascular risk factors and cerebrovascular reserve in the aged patients.Methods 700 patients with sex unlimited were selected from Zhejiang Hospital from July 2007 to July 2010.The clinical data about gender,age,smoking history,drinking history,hypertension,diabetes,dyslipidemia,bilateral carotid artery B ultrasonic examination were collected.The patients were divided into vascular risk factors group(n=400)aged(73.4± 6.8)years and control group(n=300)aged(72.4± 6.9)years.Intracranial vascular reaction was dertermined using transcranial doppler ultrasonography combined with breathholding test to calculate the breath-holding index(BHI)and evaluate cerebrovascular reserve.Results BHI in vascular risk factors group and control group were(0.57±0.18)and(0.97±0.31),respectively,and cerebrovascular reserve in the patients with vascular risk factors was decreased than without risk factors(t =10.87,P ＜ 0.01).Multifactor retrospective analysis showed hypertension,hyperlipidemia,diabetes and smoking were related with cerebrovascular reserve(F=6.51,P =0.000),and the degree to influnce from small to large was followed by diabetes,hypertention,smoking and hyperlipidemia.Conclusions Cerebrovascular reserve is damaged in the aged patients with vascular risk factors.Hypertension,hyperlipidemia,diabetes,smoking may affect cerebrovascular reserves among which the greatest influence is in diabetes.