MacSweeney S T, Young G, Greenhalgh R M, Powell J T
Department of Surgery, Charing Cross and Westminster Medical School, London, UK.
Br J Surg. 1992 Dec;79(12):1281-4. doi: 10.1002/bjs.1800791211.
The mechanical properties of the abdominal aorta were investigated non-invasively in 30 patients with aortic aneurysm and 11 with peripheral arterial disease. The distensibility of the aorta was measured using M-mode ultrasonography, permitting non-invasive assessment of the pressure--strain elastic modulus or aortic stiffness, Ep. The median Ep value increased from 4.0 N/cm2 in control subjects in their third decade of life (n = 10) to 10.4 N/cm2 in middle age (n = 11) to 14.0 N/cm2 in the elderly (n = 13). In the presence of a normal diameter, peripheral arterial disease with aortic atherosclerosis had little effect on aortic stiffness, median Ep being 16.0 N/cm2. Aneurysmal dilatation was associated with a significant increase in aortic stiffness, median Ep being 31.3 N/cm2 (P < 0.001). For aortas of normal diameter, Ep was at all ages dependent on mean arterial pressure. In patients with aortic aneurysms there was no clear relationship between Ep and mean arterial pressure or aortic diameter. Of the patients studied, 15 underwent aortic reconstruction; increasing aortic stiffness (log Ep) was associated with a decreased medial elastin content of the aortic biopsy (r = -0.63, P < 0.02). This study demonstrates the marked stiffness or inelasticity of dilated or aneurysmal vessels, part of which is attributable to the loss of elastin.
对30例主动脉瘤患者和11例周围动脉疾病患者的腹主动脉力学特性进行了无创研究。使用M型超声测量主动脉的扩张性，从而对压力-应变弹性模量或主动脉硬度Ep进行无创评估。Ep的中位数在30岁左右的对照受试者（n = 10）中为4.0 N/cm²，中年（n = 11）时为10.4 N/cm²，老年人（n = 13）时为14.0 N/cm²。在直径正常的情况下，伴有主动脉粥样硬化的周围动脉疾病对主动脉硬度影响不大，Ep中位数为16.0 N/cm²。动脉瘤样扩张与主动脉硬度显著增加相关，Ep中位数为31.3 N/cm²（P < 0.001）。对于直径正常的主动脉，Ep在所有年龄段均取决于平均动脉压。在主动脉瘤患者中，Ep与平均动脉压或主动脉直径之间没有明确的关系。在研究的患者中，15例接受了主动脉重建；主动脉硬度增加（log Ep）与主动脉活检中中层弹性蛋白含量降低相关（r = -0.63，P < 0.02）。本研究表明扩张或动脉瘤样血管具有明显的硬度或无弹性，部分原因是弹性蛋白的丧失。
