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父母中有早发心肌梗死病史者,颈动脉内膜中层厚度增加的预测因素比父母有高血压病史者更强。

Parental history of premature myocardial infarction is a stronger predictor of increased carotid intima-media thickness than parental history of hypertension.

机构信息

Cardiology Unit, A. Cardarelli Hospital, Naples, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2011 Jun;21(6):391-7. doi: 10.1016/j.numecd.2009.10.017. Epub 2010 Feb 16.

Abstract

An increased carotid intima-media thickness (IMT) is detectable in young subjects with parental history of premature myocardial infarction (PHPMI) or hypertension (PHH). In this study we evaluated if PHPMI and PHH exert a different influence on carotid IMT and if their conjunction produces additive effects. High-resolution B-mode ultrasonographic evaluation of common carotid artery IMT was acquired from 48 subjects without PHPMI and PHH (22 males, 26 females; mean age 22.1±4.9 years; controls), 24 age- (±1 year) and sex-matched subjects with PHH without PHPMI (PHH-positive/PHPMI-negative subjects), 24 age- and sex-matched subjects with PHPMI without PHH (PHH-negative/PHPMI-positive subjects) and 24 age- and sex-matched subjects with both PHPMI and PHH (PHH/PHPMI-positive subjects). Lipid profile, resting blood pressure, smoking behaviour and body mass index (BMI) were also assessed. Carotid IMT was smaller in controls (0.41±0.07mm) compared to PHH-positive/PHPMI-negative subjects (0.47±0.10, p=0.023), to PHH-negative/PHPMI-positive subjects (0.54±0.11, p<0.001) and to PHH/PHPMI-positive subjects (0.52±0.10mm, p<0.001). Carotid IMT was greater in PHH-negative/PHPMI-positive (p=0.006) and in PHH/PHPMI-positive (p=0.031) than in PHH-positive/PHPMI-negative subjects. No difference in carotid IMT was evident between PHH-negative/PHPMI-positive and PHH/PHPMI-positive subjects (p=0.549). In the comparison among subjects using multiple regression analysis, only PHPMI, age and BMI were independently associated with carotid IMT. In healthy young subjects with PHPMI and/or PHH, carotid IMT is increased. PHPMI is a stronger predictor of increased carotid IMT than PHH. PHH in conjunction with PHPMI does not add any further detrimental effect on carotid IMT.

摘要

在有早发性心肌梗死(PHPMI)或高血压(PHH)家族史的年轻患者中,颈动脉内膜中层厚度(IMT)增加是可以检测到的。在这项研究中,我们评估了 PHPMI 和 PHH 是否对颈动脉 IMT 有不同的影响,以及它们的结合是否会产生叠加效应。对 48 名无 PHPMI 和 PHH 的患者(22 名男性,26 名女性;平均年龄 22.1±4.9 岁;对照组)、24 名年龄(±1 岁)和性别匹配的仅有 PHH 而无 PHPMI 的患者(PHH-阳性/PHPMI-阴性患者)、24 名年龄和性别匹配的仅有 PHPMI 而无 PHH 的患者(PHH-阴性/PHPMI-阳性患者)和 24 名同时有 PHPMI 和 PHH 的患者(PHH/PHPMI-阳性患者)进行了高频超声检测颈动脉 IMT。还评估了血脂谱、静息血压、吸烟行为和体重指数(BMI)。对照组颈动脉 IMT 较小(0.41±0.07mm),与 PHH-阳性/PHPMI-阴性患者(0.47±0.10,p=0.023)、PHH-阴性/PHPMI-阳性患者(0.54±0.11,p<0.001)和 PHH/PHPMI-阳性患者(0.52±0.10mm,p<0.001)相比。PHH-阴性/PHPMI-阳性(p=0.006)和 PHH/PHPMI-阳性(p=0.031)患者的颈动脉 IMT 均大于 PHH-阳性/PHPMI-阴性患者。PHH-阴性/PHPMI-阳性和 PHH/PHPMI-阳性患者之间的颈动脉 IMT 无差异(p=0.549)。在使用多元回归分析进行的比较中,只有 PHPMI、年龄和 BMI 与颈动脉 IMT 独立相关。在有 PHPMI 和/或 PHH 的健康年轻患者中,颈动脉 IMT 增加。PHPMI 是颈动脉 IMT 增加的更强预测因素,而 PHH 则不然。PHH 与 PHPMI 结合对颈动脉 IMT 没有进一步的不利影响。

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