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【摘要】 目的 探讨彩色多普勒血流显像在中老年人群体检中诊断颈动脉粥样硬化的临床价值。方法 二维及彩超观察638例中老年人体检患者颈动脉，对其中432例颈动脉硬化患者的超声特点及血流情况进行分析。结果 其中动脉硬化432例，动脉粥样斑块形成245例，双侧粥样斑块形成108例，左侧粥样斑块形成61例，右侧粥样斑块形成76例，据声像图表现分为四种类型斑块：扁平斑、软斑、硬斑、溃疡斑。颈动脉狭窄患者19例。双侧病变占68．29%，单侧病变占31．71%。结论 该项检查方便、无创、定位准确，检出率可达100%，颈动脉是动脉硬化的好发部位，它的病变出现往往早于冠状动脉和脑动脉。因而彩超对颈动脉粥样硬化斑块的诊断具有较高的临床价值，尤其是无症状的早期病变，可使患者得到早期治疗。�
【关键词】 颈动脉；体检；动脉粥样硬化；彩色多普勒��
Effect of UCG in physical examination of elderly or middle-aged men.
HUANG Wei-dong， LI Can．Ultrasound Dept． South Institution，No．1 Hospital of Chenzhou，Hunan 423000，China�
【Abstract】 Objective To analysis the clinical value of color doppler flow ultrasound in diagnosing elderly or middle-aged men’s carotid artery atherosclerosis．Methods Use two dimensions and high frequency color dopplar ultrasound to observe 638 elderly or middle-aged men’s carotid artery which is in physical exami-nation.
Selected 432 patients, analysised the feature of carotid artery atherosclerosis and blood stream situation. Results 432patients were troubled by artery atherosclerosis, 245 patients were troubled by artery atherosclerosis plaque, 108 patients were troubled by double artery atherosclerosis plaque,61 patients were troubled by left artery atherosclerosis plaque,76 patients were troubled by right artery atherosclerosis plaque, according to the manifest of sonogram echogram,types of plaques: flat plaque, soft plaque, hard plaque, ulcer plaque. 19 patients were carotid artery narrow, 68．29%of them were double side pathological changes, 31．71%of them were unilateral pathological changes. Conclusions This inspection is convenient, no hurt, accurate location, the detectable rate is 100%. Carotid artery is the fit to contract artery atherosclerosis, it changes early than coronary artery and brain artery. So UCG has upper clinical value to the diagnosis of artery atherosclerosis plaque, especially to asymptomatic early period pathological changes,for the patients can be cure in early stage.�
【Key words】 Carotid artery ; Physical examination; Artery atherosclerosis plaque; Color doppler flow ultrasound
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1 资料与方法�
1．1 一般资料 本组638例为2007年3月至2008年6月来本院体检中心常规体检人群，男460例，女178例，年龄50~93岁，平均67岁。�
1．2 采用仪器 使用超声仪为美国GEVivid 7 Dimension 型彩色多普勒超声诊断仪，探头型号12 L。�
1．3 方法 检查时取平卧位，头部偏向检查对侧，充分暴露颈部，沿胸锁乳突肌外缘纵切扫查，依次显示颈总动脉至分叉处分别探查颈内动脉和颈外动脉，扫查后将探头转90°；沿血管走行做横扫。观察指标：颈总动脉内径(于分叉前2 cm处测量)；颈内、外动脉内径(距分叉后2 cm处分别测量)；颈动脉内膜中层厚度，正常颈总动脉内-中膜厚度＜1．0 mm，分叉处＜1．2 mm[1]；斑块的部位、大小、回声；估测管腔狭窄的程度，狭窄程度(%)=(B-A)/B×100%，A为狭窄处残留管腔的内径或彩色血流宽度，B为狭窄远端或近端正常动脉管腔内径或彩色血流宽度[2]。�
2 结果�
638例中老年人体检患者动脉硬化432例，动脉粥样斑块形成245例，双侧粥样斑块形成108例，左侧粥样斑块形成61例，右侧粥样斑块形成76例，颈动脉狭窄患者19例。双侧病变占68．29%，单侧病变占31．71%。245例中根据斑块的大小、回声特点分为4型：扁平斑、软斑、硬斑、溃疡斑。245例均经超声检出颈动脉粥样斑块，本组双侧病变29例占80．55%，单侧病变7例占19．45%。颈总动脉、颈内动脉及分叉处共有58处斑块，其中左侧35处，右侧23处，7例颈总动脉内膜中层厚度增厚1．1~1．3 mm，其中3例明显增厚达1．6 mm，粗糙不平，2例颈总动脉发生狭窄，狭窄程度[3]。因此，对于中老年人应将此项检查作为一种常规检查手段，该检查不仅可以为有症状的患者提供各项具有重要预后价值的指标，也可为无症状期的动脉硬化患者进行检查和监测，早期采取有效的预防和治疗措施。�
参考文献
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［2］ 徐智章.脑梗塞患者颈动脉超声检测.中国医学影像技术,1996，12(5):321-322.�
［3］ 张青萍.现代超声显像鉴别诊断学.江西科学技术出版社,1999:753.�
