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老年高胆固醇血症患者胸主动脉和颈动脉动脉粥样硬化的磁共振成像与超声检查

[MRI and ultrasonography of atherosclerosis of the thoracic aorta and carotid arteries in elderly hypercholesterolemic patients].

作者信息

Yamauchi Y, Kohda E, Hisa N

机构信息

Institute for Adult Medicine, Keio University.

出版信息

Nihon Ronen Igakkai Zasshi. 1991 Sep;28(5):657-63. doi: 10.3143/geriatrics.28.657.

Abstract

In 53 elderly participants aged more than 60 the thoracic aorta and bilateral carotid arteries were observed with noninvasive techniques, MRI and ultra-sonography, in order to elucidate the relationship between hypercholesterolemia and atherosclerosis in the elderly. Hypercholesterolemic subjects were classified as group H (serum total cholesterol (TC) greater than 220 mg/dl), group H-I (220 mg/dl less than TC less than 250 mg/dl) and group H-II (TC greater than or equal to 250 mg/dl). Atherosclerotic changes of the thoracic aorta were observed in 46% of group H, 27% of group H-I, 60% of group H-II and 37% of normolipidemic subjects (group NL). Carotid atherosclerotic changes were observed in 19% of group H, 9% of group H-I, 27% of group H-II and 18% of group NL. In group H-I, the percentages of atherosclerotic changes in both thoracic aorta and carotid arteries were lower than those in group NL. However, atherosclerotic changes of thoracic aorta and carotid arteries were detected in 43% and 29% of the subjects showing higher apo B/Apo Al ratio than 1.0 among group H-I + NL (TC less than 250 mg/dl). These changes occurred in 32% and 13% of the subjects showing lower apo B/Apo Al ratio than 1.0 among the same groups. Namely, atherosclerotic changes of the thoracic aorta and carotid arteries were observed more frequently in the subjects showing a higher apo B/Apo Al ratio than 1.0 even if their serum cholesterol values were not higher than 250 mg/dl. We should use not only the serum cholesterol value but also the apo B/Apo Al ratio as an indicator to evaluate the roles of lipids in the development of atherosclerosis.

摘要

在53名年龄超过60岁的老年参与者中,采用无创技术(MRI和超声检查)对胸主动脉和双侧颈动脉进行观察,以阐明老年人高胆固醇血症与动脉粥样硬化之间的关系。高胆固醇血症患者分为H组(血清总胆固醇(TC)大于220mg/dl)、H-I组(220mg/dl<TC<250mg/dl)和H-II组(TC≥250mg/dl)。H组中46%的患者观察到胸主动脉有动脉粥样硬化改变,H-I组为27%,H-II组为60%,血脂正常组(NL组)为37%。H组中19%的患者观察到颈动脉有动脉粥样硬化改变,H-I组为9%,H-II组为27%,NL组为18%。在H-I组中,胸主动脉和颈动脉的动脉粥样硬化改变百分比低于NL组。然而,在H-I组+NL组(TC<250mg/dl)中,载脂蛋白B/载脂蛋白A1比值大于1.0的受试者中,分别有43%和29%检测到胸主动脉和颈动脉有动脉粥样硬化改变。在同一组中,载脂蛋白B/载脂蛋白A1比值小于1.0的受试者中,分别有32%和13%出现这些改变。也就是说,即使血清胆固醇值不高于250mg/dl,载脂蛋白B/载脂蛋白A1比值大于1.0的受试者中,胸主动脉和颈动脉的动脉粥样硬化改变更常见。我们不仅应将血清胆固醇值,还应将载脂蛋白B/载脂蛋白A1比值作为评估脂质在动脉粥样硬化发展中作用的指标。

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