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心血管危险因素对年轻患者动脉硬化进展的影响:通过颈动脉双功超声和心踝血管指数(CAVI)进行评估。

Impact of cardiovascular risk factors on progression of arteriosclerosis in younger patients: evaluation by carotid duplex ultrasonography and cardio-ankle vascular index(CAVI).

作者信息

Suzuki Jun, Kurosu Takumi, Kon Tokuo, Tomaru Takanobu

机构信息

Department of Clinical Physiology, Toho University Medical Center Sakura Hospital.

出版信息

J Atheroscler Thromb. 2014;21(6):554-62. Epub 2014 Feb 13.

Abstract

AIM

To evaluate progression of arteriosclerosis using cardio-ankle vascular index(CAVI) and carotid duplex ultrasonography(DUS) in young and adolescent patients considered to be at risk of cardiovascular disease.

METHODS

We evaluated the progression of arteriosclerosis using CAVI and carotid DUS in 240 young and adolescent patients. Dyslipidemia(DL), hypertension(HT), and diabetes mellitus(DM) were major cardiovascular risk factors. Patients were divided to 4 groups according to number of risk factors.

RESULTS

In terms of risk factors, CAVI and CAVI difference(CAVI-D) were elevated only in the HT group(p=0.0290, p=0.0243 vs. no risk respectively). CAVI-D was positively associated with diastolic blood pressure(DBP). Mean IMT was positively associated with LDL-C or systolic blood pressure, and negatively with HDL-C. Plaque score was associated with LDL-C or DBP. In patients with the 3 risk factors, CAVI, CAVI-D and mean intima-media thickness(IMT) were significantly higher than in those without risk(p=0.0009, p=0.0042 and p=0.0151 respectively), and CAVI and CAVID were higher than in those with 1 risk(p=0.0204 and p=0.0231). Carotid plaque develops from around 30 years of age in Japan. Despite numbers of risk factors, there were no differences in CAVI, CAVI-D, mean IMT or plaque score between smoker and non-smoker groups.

CONCLUSION

In conclusion, an increase in the number of risk factors also results in progression of arteriosclerosis in young and adolescent patients. HT was the most important risk factor for arteriosclerosis in these patients.

摘要

目的

使用心踝血管指数(CAVI)和颈动脉双功超声(DUS)评估被认为有心血管疾病风险的年轻及青少年患者的动脉硬化进展情况。

方法

我们使用CAVI和颈动脉DUS对240名年轻及青少年患者的动脉硬化进展情况进行了评估。血脂异常(DL)、高血压(HT)和糖尿病(DM)是主要的心血管危险因素。患者根据危险因素的数量被分为4组。

结果

就危险因素而言,仅HT组的CAVI和CAVI差值(CAVI-D)升高(分别与无危险因素组相比,p = 0.0290,p = 0.0243)。CAVI-D与舒张压(DBP)呈正相关。平均内膜中层厚度(IMT)与低密度脂蛋白胆固醇(LDL-C)或收缩压呈正相关,与高密度脂蛋白胆固醇(HDL-C)呈负相关。斑块评分与LDL-C或DBP相关。在有三种危险因素的患者中,CAVI、CAVI-D和平均内膜中层厚度(IMT)显著高于无危险因素的患者(分别为p = 0.0009,p = 0.0042和p = 0.0151),且CAVI和CAVI-D高于有一个危险因素的患者(p = 0.0204和p = 0.0231)。在日本,颈动脉斑块大约从30岁开始出现。尽管存在多种危险因素,但吸烟组和非吸烟组之间在CAVI、CAVI-D、平均IMT或斑块评分方面没有差异。

结论

总之,危险因素数量增加也会导致年轻及青少年患者动脉硬化进展。HT是这些患者动脉硬化的最重要危险因素。

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