超声射频分析技术无创评价血脂异常患者颈动脉内中膜厚度与动脉弹性

摘要

Objective To assess the value of ultrasonic radio frequency analysis technique for noninvasively evaluation of carotid artery intima-media thickness (IMT) and elasticity in patients with dyslipidemia. Methods Radio frequency quality intima-media thickness (RFQIMT) technique and radio frequency quality arterial stiffness (RFQAS) technique were used for measurement of IMT and pulse wave velocity (PWV) of the left carotid artery in 86 patients with dyslipidemia and 60 healthy volunteers. Results Apart from the patients' age, body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, fasting blood glucose, IMT and PWV differed significantly between the control and case groups. IMT was positively correlated with PWV (r=0.521, P<0.05). In patients with IMT<1.0 mm (n=81), PWV differed significantly between patients with different number of other atherogenic risk factors (P=0.004), but IMT showed no such variation (P=0.079). In patients with more than 3 and those with 2 other risk factors, PWV increased significantly as compared with those with one risk factor (P=0.002). Multiple linear regression analysis showed that systolic blood pressure, age and fasting blood glucose were independently associated with PWV. Conclusion Ultrasonic radio frequency analysis technique allows accurate measurement of IMT and arterial elasticity, and may thus become a valuable method for evaluating early structural and arterial functional change of the carotid artery.%目的：应用超声射频分析技术无创评价血脂异常患者的颈动脉内中膜厚度和动脉弹性。方法随机选取健康志愿者60例为对照组，血脂异常患者86例为病例组，应用超声射频分析技术对所有参与者左颈动脉进行检查，获得颈动脉的内中膜厚度（IMT）和单点脉搏波传导速度（PWV），并进行统计学分析。结果对照组和病例组的年龄无统计学差异（P>0.05），体质量比、收缩压、舒张压、脉压、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、空腹血糖、IMT和PWV差异有统计学意义（P<0.05）。IMT和PWV的相关性比较显示两者呈正相关（r=0.521，P<0.05）。在IMT<1.0 mm的病例中（n=81），随合并其他动脉硬化高危因素的数目不同而IMT的测值差异无统计学意义（P=0.079），PWV的测值具有统计学差异（P=0.004），其中合并≥3个和2个危险因素者较1个高危因素的PWV测值增加（P值均为0.002）。多重回归分析显示收缩压、年龄和空腹血糖是影响血脂异常患者PWV的重要因素。结论超声射频分析技术可较准确测量颈动脉IMT和动脉弹性，有望成为评价颈动脉早期结构和弹性功能改变的有效手段。