Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Ultrasound Med. 2019 Jun;38(6):1545-1552. doi: 10.1002/jum.14843. Epub 2018 Nov 6.
To investigate carotid intima-media roughness (IMR) in hypertensive patients with normal carotid intima-media thickness (IMT) using automatic identification software and the correlation between carotid IMR and risk factors.
This case-control study comprised 61 hypertensive patients with normal carotid IMT and 51 control participants. Carotid IMR, carotid IMT, pulsed wave velocity (PWV), stiffness (β), and arterial compliance were determined by carotid ultrasound and image postprocessing using an automatic identification program and echo-tracking analysis software.
Carotid IMR, mean carotid IMT, maximum carotid IMT, β, and PWV in the hypertension group were higher than those in the control group (58.24 versus 34.61 μm, 641.17 versus 576.48 μm, 746.82 versus 640.55 μm, 9.42 versus 7.35, and 7.10 versus 5.86 m/s, respectively; P < .05), and arterial compliance was lower than that in the control group (0.70 versus 0.95 mm /kPa; P < .05). Intima-media roughness was correlated with maximum IMT, mean IMT, PWV, β, age, diagnosis of hypertension for greater than 1 year, and pulse pressure. Multivariate logistic regression showed that age, diagnosis of hypertension for greater than 1 year, and pulse pressure were influential factors for IMR in hypertensive patients, with odds ratios of 6.719 (95% confidence interval, 1.658-27.221; P = .008), 4.726 (95% confidence interval, 1.174-19.022; P = .029), and 3.998 (95% confidence interval, 1.033-15.466; P = .045), respectively.
Carotid IMR and the elasticity index have important clinical importance in evaluating the risk of early atherosclerosis in hypertensive populations.
应用自动识别软件检测颈动脉内膜中层厚度（IMT）正常的高血压患者的颈动脉内膜中层粗糙度（IMR），并分析颈动脉 IMR 与危险因素的相关性。
本病例对照研究纳入了 61 例颈动脉 IMT 正常的高血压患者和 51 例对照组参与者。采用颈动脉超声和自动识别程序及回声跟踪分析软件进行图像后处理，检测颈动脉 IMR、颈动脉 IMT、脉搏波速度（PWV）、僵硬度（β）和动脉顺应性。
高血压组的颈动脉 IMR、平均颈动脉 IMT、最大颈动脉 IMT、β 和 PWV 均高于对照组（58.24μm 比 34.61μm、641.17μm 比 576.48μm、746.82μm 比 640.55μm、9.42 比 7.35、7.10 比 5.86m/s；P<0.05），动脉顺应性则低于对照组（0.70 比 0.95mm/kPa；P<0.05）。内膜中层粗糙度与最大 IMT、平均 IMT、PWV、β、年龄、高血压诊断时间大于 1 年和脉压相关。多因素 logistic 回归分析显示，年龄、高血压诊断时间大于 1 年和脉压是高血压患者 IMR 的影响因素，其比值比分别为 6.719（95%置信区间：1.658-27.221；P=0.008）、4.726（95%置信区间：1.174-19.022；P=0.029）和 3.998（95%置信区间：1.033-15.466；P=0.045）。
在评估高血压人群早期动脉粥样硬化风险方面，颈动脉 IMR 和弹性指数具有重要的临床意义。
