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单独测量颈动脉壁以评估动脉粥样硬化危险因素的临床意义。

The Clinical Significance of Separate Measurements of Carotid Arterial Wall to Assess the Risk Factor for Atherosclerosis.

作者信息

Kim Ji-Hoon, Youn Ho-Joong, Kim Gee-Hee, Moon Keon-Woong, Yoo Ki-Dong, Kim Chul-Min

机构信息

Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.

Division of Cardiology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

J Cardiovasc Ultrasound. 2016 Mar;24(1):48-54. doi: 10.4250/jcu.2016.24.1.48. Epub 2016 Mar 24.

Abstract

BACKGROUND

Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established.

METHODS

Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary's Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer).

RESULTS

In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R(2) = 0.256) and the IT/MT ratio (R(2) = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R(2) = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R(2) = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R(2) = 0.265) and mean CIMT (R(2) = 0.243) on the left side.

CONCLUSION

We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis.

摘要

背景

颈动脉内膜中层厚度(CIMT)与动脉粥样硬化的多种危险因素相关,并一直与心血管和脑血管疾病存在关联。CIMT是内膜(IT)和中层厚度(MT)之和,单独测量CIMT作为动脉粥样硬化风险评估指标的临床意义尚未完全明确。

方法

在2003年9月至2009年3月于圣玛丽医院内科接受颈动脉B型超声检查和冠状动脉造影的3377例患者中,选取1146例(男∶女 = 616∶530;平均年龄57.7±12.1岁)被诊断为冠状动脉正常的受试者纳入本研究。使用高频超声(15 MHz线性阵列探头)手动测量入选患者的IT、MT和CIMT。

结果

在多因素逻辑回归分析中,年龄(β = 0.063,p < 0.0001)、体重指数(BMI)(β = 0.028,p = 0.018)和高血压(HTN)(β = 0.046,p = 0.0002)与MT(R² = 0.256)及IT/MT比值(R² = 0.209)相关。年龄(β = 0.065,p < 0.0001)、BMI(β = 0.025,p = 0.038)、糖化血红蛋白(β = 0.045,p = 0.045)和HTN(β = 0.043,p = 0.0006)与平均CIMT(R² = 0.230)相关。年龄(β = -0.071,p < 0.0001)和BMI(β = -0.046,p = 0.002)与左侧IT/MT比值(R² = 0.219)相关。年龄(β = 0.093,p < 0.0001)与左侧MT(R² = 0.265)及平均CIMT(R² = 0.243)相关。

结论

我们注意到不同的动脉粥样硬化危险因素以不同方式与动脉壁测量值相关。因此,单独测量CIMT可能是评估动脉粥样硬化风险的一种有用方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3608/4828414/159ab9c6c7ee/jcu-24-48-g001.jpg

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