腹主动脉瘤及外周血管病患者的颈动脉超声特征分析研究

摘要

Objective:To study the ultrasonic feature of carotid artery in patients with abdominal aortic aneurysms and peripheral arterial disease,and to explore the pathogenesis of atherosclerosis in those two diseases.Methods: Our work included three groups as Abdominal aortic aneurysms group, n = 67, the patients were diagnosed by CTA, Peripheral arterial disease group,n= 86, the patients were diagnosed by DSA,and Control group, n = 46, the subjects were from regular physical check-up. Intimal-media thickness( IMT )was measured with high frequency B-mode ultrasonography, the loca-tion, quantity and properties of carotid atherosclerotic plaque were examined and compared in different groups.Results: In Abdominal aortic aneurysms group and Peripheral arterial disease group,the occurrence of carotid artery plaque, the total score of carotid artery plaque and the mean IMT value were significant higher in male than those in female,P<0. 05. With the same gender, the mean IMT value and the total score of carotid artery plaque were obviously higher in Peripheral arterial dis-ease group than those in the other two groups,P<0. 001. With the adjusted gender factor, the mean IMT value, the occurrence of carotid artery plaque and the total score of carotid artery plaque were all higher in Peripheral arterial disease group than those in the other two groups,P<0. 001. There were no real differences between Abdominal aortic aneurysms group and Control group,P> 0. 05. There were more patients combined with coronary artery disease and stroke in Peripheral arterial disease group than the oth-er two groups,P<0. 001.Conclusion:Atherosclerosis is an important pathogenesis in peripheral arterial disease. Atherosclerosis has little effect in ab-dominal aortic aneurysm formation.%目的:分析比较腹主动脉瘤及外周血管病患者的颈动脉超声特征,探讨动脉粥样硬化在腹主动脉瘤及外周血管病发病机制中的作用.方法:选取经计算机断层摄影血管造影术(CTA)检查确诊的腹主动脉瘤患者67例(腹主动脉瘤组),经数字减影血管造影术(DSA)及外周血管超声检查确诊的外周血管病患者86例(外周血管病组),同期正常体检人群46例(正常对照组),应用彩色多普勒超声检测入选者的颈动脉内一中膜厚度(IMT),观察颈动脉斑块数量及性质等,并将三组检测结果进行对比分析.结果:在腹主动脉瘤组和外周血管病组中,男性的颈动脉斑块发生率、颈动脉斑块总积分及平均颈动脉IMT值均显著高于女性(P<0.05);同性别内,外周血管病组的平均颈动脉IMT值、颈动脉斑块发生率、颈动脉斑块总积分均显著高于腹主动脉瘤组和正常对照组(P<0.001);经性别校正后,外周血管病组的平均颈动脉IMT值、颈动脉斑块发生率及颈动脉斑块总积分均高于腹主动脉瘤组及正常对照组,差异有统计学意义(P<0.001);而腹主动脉瘤组与正常对照组两者之间差异无统计学意义(P>0.05),外周血管病组合并冠心病例数及脑卒中的例数明显高于腹主动脉瘤组和正常对照组,差异有统计学意义(P<0.001).结论:颈动脉超声可以反映全身动脉粥样硬化,本文通过颈动脉超声研究证明动脉粥样硬化是外周血管病的重要致病因素,动脉粥样硬化在腹主动脉瘤的形成中所起的作用极小.