Cheuk Bernice L Y, Lau Silvana S F, Cheng Stephen W K
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
Eur J Vasc Endovasc Surg. 2007 Feb;33(2):149-53. doi: 10.1016/j.ejvs.2006.09.008. Epub 2006 Nov 9.
The contribution of atherosclerosis to the development of Abdominal Aortic Aneurysms (AAA) is still controversial. Ultrasound scans can detect intima-media thickening of the carotid arteries as an early sign of atherosclerosis. The aim of this study was to investigate whether patients with Abdominal Aortic Aneurysms (AAAs) have thickened carotid IMT as patients with atherosclerotic peripheral arterial disease (PAD).
With high-resolution B-mode ultrasonography, the intima-media thickness (IMT) in the carotid arteries (right and left common carotid artery) was measured in AAA patients and compared with that of age and sex-matched patients with atherosclerotic peripheral arterial disease (PAD). A third group of healthy age and sex- matched control subjects were included for comparison. The corresponding carotid artery lumen was also determined in all groups. Comparison of the three groups was made by ANOVA.
Fifty-eight AAA patients and 69% were men (mean age of 72.3 years) were studied. Aged and sex-matched groups comprised of 111 PAD patients and 71 healthy. The mean carotid IMT was highest in PAD patients (1.036+/-0.18mm). The values of controls and AAA patients were similar and significantly lower than that of atherosclerotic patients (0.875+/-0.11mm and 0.812+/-0.53mm respectively, both p<0.005 vs. PAD). Narrowing of the corresponding lumen was found in PAD patients compared with that of AAA patients, but no difference can be seen between healthy subjects and AAA patients. The mean carotid IMT was greater in men (P<0.05) in all studied groups, but no similar gender specificity was found in the lumen diameter.
This study shows that the carotid artery IMT of AAA patients is similar to healthy subjects, but not as thick as patients with atherosclerotic disease. As carotid (IMT) is a surrogate marker of atherosclerosis, the findings support the notion that the formation of AAA may not be fully atherosclerosis-dependent. Gender may be a confounding factor for carotid intima-media thickening.
动脉粥样硬化对腹主动脉瘤（AAA）发展的作用仍存在争议。超声扫描可检测到颈动脉内膜中层增厚，这是动脉粥样硬化的早期迹象。本研究的目的是调查腹主动脉瘤（AAA）患者的颈动脉内膜中层厚度（IMT）是否与动脉粥样硬化性外周动脉疾病（PAD）患者一样增厚。
采用高分辨率B型超声测量AAA患者双侧颈总动脉的内膜中层厚度（IMT），并与年龄和性别匹配的动脉粥样硬化性外周动脉疾病（PAD）患者进行比较。纳入第三组年龄和性别匹配的健康对照者进行比较。所有组均测定相应的颈动脉管腔。三组间比较采用方差分析。
研究了58例AAA患者，其中69%为男性（平均年龄72.3岁）。年龄和性别匹配组包括111例PAD患者和71例健康者。PAD患者的平均颈动脉IMT最高（1.036±0.18mm）。对照组和AAA患者的值相似，且显著低于动脉粥样硬化患者（分别为0.875±0.11mm和0.812±0.53mm，与PAD组相比均p<0.005）。与AAA患者相比，PAD患者相应管腔变窄，但健康受试者与AAA患者之间未见差异。所有研究组中男性的平均颈动脉IMT更大（P<0.05），但管腔直径未发现类似的性别特异性。
本研究表明，AAA患者的颈动脉IMT与健康受试者相似，但不如动脉粥样硬化疾病患者厚。由于颈动脉（IMT）是动脉粥样硬化的替代标志物，这些发现支持AAA的形成可能并非完全依赖动脉粥样硬化的观点。性别可能是颈动脉内膜中层增厚的一个混杂因素。
