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[根据超声检查结果看超重和肥胖人群中大型血管的状况]

[The status of large vessels in overweight and obesity according to ultrasound findings].

作者信息

Khovaeva Ya B, Batalova A A, Golovskoy B V, Gerasimova А V

机构信息

Acad. E.A. Wagner Perm State Medical University, Ministry of Health of Russia, Perm, Russia.

出版信息

Ter Arkh. 2016;88(4):29-34. doi: 10.17116/terarkh201688429-34.

Abstract

AIM

To investigate the impact of overweight and obesity on the structure and function of large arteries in apparently healthy individuals; to estimate the magnitude of atherosclerotic lesions of the vessels.

MATERIALS AND METHODS

Sixty-one apparently healthy individuals with varying weights were randomly examined. All the examinees were divided into 3 groups according to their body mass index (BMI) and blood pressure (BP). They all underwent ultrasonography of the brachiocephalic arteries at the extracranial level, as well as the abdominal aorta and femoral arteries.

RESULTS

The overweight and obese persons have increased diameters and thickness of the intima-media complex of the common carotid arteries and aorta. These changes are maximally pronounced in obesity in conjunction with high normal BP (systolic BP, 130-139 mm Hg; diastolic BP, 85-89 mm Hg). At the same time, there is a reduction in blood flow velocities and an increase in arterial wall stiffness. More marked structural and functional changes are observed in persons with abdominal obesity. The femoral artery belonging to muscular ones exhibited no structural changes, but displayed reduced blood flow velocities in obesity concurrent with high normal BP. In all the groups, the spread of atherosclerotic plaques is equal; the latter are recorded in one third of the examinees. However, the degree and incidence of vascular atherosclerosis are higher in overweight and obesity concurrent with high normal BP.

CONCLUSION

The overweight and obese persons without cardiovascular diseases were found to have eccentric remodeling of elastic and muscular-and-elastic vessels: the carotid arteries and aorta in conjunction with increased intima-media thickness, reduced blood flow velocities, and atherosclerotic vascular changes. These changes are most pronounced in the obese persons with high normal BP. In all the groups, atherosclerotic changes are encountered mainly in the brachiocephalic arteries at the extracranial level.

摘要

目的

研究超重和肥胖对表面健康个体大动脉结构和功能的影响;评估血管动脉粥样硬化病变的程度。

材料与方法

随机检查61名体重各异的表面健康个体。所有受检者根据体重指数(BMI)和血压(BP)分为3组。他们均接受了颅外水平的头臂动脉、腹主动脉和股动脉的超声检查。

结果

超重和肥胖者颈总动脉和主动脉内膜中层复合体的直径和厚度增加。这些变化在肥胖合并血压略高于正常(收缩压130 - 139 mmHg;舒张压85 - 89 mmHg)时最为明显。同时,血流速度降低,动脉壁僵硬度增加。腹部肥胖者观察到更明显的结构和功能变化。属于肌性动脉的股动脉未出现结构变化,但在肥胖合并血压略高于正常时血流速度降低。在所有组中,动脉粥样硬化斑块的分布相同;三分之一的受检者有斑块。然而,超重和肥胖合并血压略高于正常时,血管动脉粥样硬化的程度和发生率更高。

结论

发现无心血管疾病的超重和肥胖者存在弹性血管和肌性 - 弹性血管的偏心重塑:颈动脉和主动脉伴有内膜中层厚度增加、血流速度降低以及动脉粥样硬化血管变化。这些变化在血压略高于正常的肥胖者中最为明显。在所有组中,动脉粥样硬化变化主要出现在颅外水平的头臂动脉。

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