畲族自然人群脉压与双侧颈动脉血管功能的关联研究

摘要

目的 了解畲族自然人群双侧颈总动脉内中膜厚度(IMT)的变化,判断脉压水平对双侧颈总动脉结构影响的异同性.方法 采用"中国动脉僵硬度评价研究"的方法,433名畲族人来自福建省福安市城乡自然人群,年龄15～87(49.03±13.54)岁.根据该人群脉压三分位数水平分为三组:脉压≤48 mm Hg(1 mm Hg=0.133 kPa)、49～59 mm Hg和>59mm Hg.应用超声射频信号血管内中膜分析技术(QIMT)和常规二维超声分别观察记录静息状态下双侧颈总动脉.测量舒张末期IMT,比较双侧颈动脉IMT在各组间的差异和变化趋势,分析其与年龄、体重指数、脉压、总胆固醇、甘油三酯(TG)等危险因素之间的关联.结果 (1)双侧颈动脉IMT随脉压增加而增厚,趋势检验差异有统计学意义(P<0.01).左侧颈总动脉(LCC)IMT在第1分位组与第2分位组间的差异无统计学意义(P>0.05),但均与第3分位组的差异有统计学意义(P<0.05).右侧颈总动脉(RCC)IMT在三组间的差异均有统计学意义(P<0.01).(2)多元线性回归结果表明,进入颈总动脉IMT回归方程的顺序和关联因素.左侧为年龄、脉压、体重、低密度脂蛋白胆固醇(LDL-C)、血糖和TG,其回归方程LCC-IMT=32.61+4.29(年龄)+1.77(脉压)+1.87(体重)+16.52(LDL.C)+11.77(血糖)-9.92(TG),r=0.663,r2=0.44,P<0.001;右侧为年龄、脉压和身高,其回归方程RCC-IMT=5.19(年龄)+1.61(脉压)+2.62(身高)-219.36,r=0.636,r2=0.41,P<0.001.结论 畲族自然人群双侧颈动脉IMT随脉压变化存在差异,与年龄、脉压、体重、LDL-C、血糖、TG和身高明显相关.%Objective To study the changes of intima-media thickness (IMT) in ambi-common carotid arteries(ambi-CCA)and how they correlated with factors related to quality intima-media thickness(QIMT).Methods According to the Chinese Arterial Stiffness Evaluation (CASE)project,the IMT of (ambi-CCA)was measured by QIMT and 2-D ultrasound respectively in 433 She people aged 15-87(mean 49.03±13.54).Diffrence and tendency were analyzed on age,gender,body mass index(BMI),pulse pressure(PP),total cholesterol(TC),and triglyceride.The whole population was classified into 3 groups by tertiles of pulse pressure.Results (1)Significant positive correlations were found between ambi-CCA IMT and pulse pressure(P<0.01).There was no significant difference between tertilel and tertile 2 of IMT in the left CCA(P>0.05)found,but with significant difference among the tertile groups,respectively(P<0.05).There were significant differences among the three groups of IMT in the right CCA,respectively(P<0.01).(2)The regression factors of IMT in left CCA were age,pulse pressure,weight,LDL-C,blood glucose (BG), TG , and theirregression equation was LCC-IMT=32.61 + 4.29 (age) + 1.77 (PP) + 1.87(weight) + 16.52(LDL-C) + 11.77(BG)-9.92(TG), with r=0.663 and r2=0.44, (P<0.001). The regression factors of IMT in right CCA were age, PP, height and their regression equation was RCC-IMT=5.19(age) + 1.61 (PP) +2.62(height) -219.36,with r=0.636 and r2=0.41 (P<0.001).Conclusion There were differences seen on IMT of CCA in the PP and position and were correlated with age, PP, body weight, LDL-C, BG, TC and body height. The difference of ambi-CCA should be called for attention.