Kazmierski Radoslaw, Watala Cezary, Podsiadly Edyta, Dorszewska Jolanta, Kozubski Wojciech
Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, L. Bierkowski Hospital, Poznan, Poland.
J Clin Ultrasound. 2009 Jul-Aug;37(6):333-41. doi: 10.1002/jcu.20585.
There is increasing evidence that adventitial inflammation may participate in atherosclerosis development. The aim of this study was to investigate which atherosclerotic risk factors correlated with carotid adventitial thickness (AT) and to compare them with those associated with carotid intima-media thickness (IMT). We also set out to test the hypothesis that there is a significant correlation between IMT and AT in the carotid arteries.
The far carotid artery wall IMT and AT were measured by high-resolution B-mode ultrasound in 128 persons (mean, 65 +/- 8 years). A number of conventional and novel, clinically and laboratory-derived risk factors were assessed.
Significant correlation (r = 0.35, p < 0.0001) was demonstrated between the IMT and AT. The stepwise forward multiple regression analysis revealed correlations between IMT and leukocyte count, C-reactive protein level, and hypertension, whereas the Chlamydia (C.) pneumoniae IgA antibodies and fibrinogen levels, gender, and smoking correlated merely with AT. The homocysteine/methionine ratio correlated with both IMT and AT.
The association between IMT and AT may reflect an interaction between intimal, medial, and adventitial pathology. Different risk factors are associated with the increased AT or IMT. It is possible that inflammation and some chronic infections, such as those induced by C. pneumoniae, could have a marked influence on adventitial cell proliferation.
越来越多的证据表明外膜炎症可能参与动脉粥样硬化的发展。本研究的目的是调查哪些动脉粥样硬化危险因素与颈动脉外膜厚度（AT）相关，并将它们与那些与颈动脉内膜中层厚度（IMT）相关的危险因素进行比较。我们还着手检验颈动脉IMT与AT之间存在显著相关性这一假设。
采用高分辨率B型超声测量了128名患者（平均年龄65±8岁）的颈动脉远侧壁IMT和AT。评估了一些传统和新型的、临床及实验室衍生的危险因素。
IMT与AT之间存在显著相关性（r = 0.35，p < 0.0001）。逐步向前多元回归分析显示IMT与白细胞计数、C反应蛋白水平和高血压之间存在相关性，而肺炎衣原体IgA抗体、纤维蛋白原水平、性别和吸烟仅与AT相关。同型半胱氨酸/蛋氨酸比值与IMT和AT均相关。
IMT与AT之间的关联可能反映了内膜、中膜和外膜病理之间的相互作用。不同的危险因素与AT或IMT增加相关。炎症和一些慢性感染，如肺炎衣原体引起的感染，可能对外膜细胞增殖有显著影响。
