目的 探讨颈动脉斑块与斑块生长部位、血流动力学指标以及内膜之间的相关关系.方法 对18 248例受检者根据颈总动脉(CCA)有无斑块与内-中膜厚度的关系分为7组,分别观测双侧CCA内-中膜厚度(IMT)和斑块的有无,及双侧颈总动脉血流指标变化:收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、血管阻力指数(RI)、血管搏动指数(PI)、PSV/EDV.结果 (1) CCA斑块的分布 两侧同时存在最高,左侧高于右侧；IMT增厚双侧同时受累最高,左侧高于右侧；(2)与CCA无斑块组相比,CCA有斑块组的PSV、EDV减低,PI和RI增高,双侧都有斑块者PSV、EDV降低和PI、RI增高最为显著.与IMT正常组相比,IMT增厚组PSV、EDV降低,PI和RI增高.结论 CCA斑块的形成和IMT的增厚均表现为双侧受累最多,且左侧高于右侧；而且双侧的受累对血流动力学的影响最大.%Objective To explore the correlation of atherosclerotic plaque and its site, the index of hemodynamics and vascular intima in carotid arteria. Methods 18 248 cases were divided into 7 groups according to the presence or absence of plaque in the common carotid artery (CCA) and the thickness of vascular intima. The intima-media thickness (IMT), the presence of plaque and the index of blood flow in the bilateral CCA including peak systolic velocity (PSV), end of diastolic velocity (EDV), resistance index (RI), pulsatility index (PI) and PSV/EDV were measured. Results (1) The distribution of the plaque in CCA: bilateral plaque and thickened IMT accounted for the majority, and the percentage of plaque in the left side was higher than the right side; (2) Compared with the non-plaque group, velocity were lower in the plaque group, but higher in PI and RI. The decrease in PSV and EDV, as well as the rise in PI and RI were most obvious in bilateral carotid plaque group. In comparison with the group with normal IMT, the group of thickered IMT indicated decline in PSV and EDV, but increase in PI and RI. Conclusions Most of the subjects with thickened IMT and plagues were bilateral, and there were more left-side than right-side. And the bilateral group had the greatest impact on hemodynamics.
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