Liu Guyue, Xu Qing, Sun Min, Xiao Rong
Department of Ultrasound, Chengdu Office Hospital of Tibet Autonomous Region People's Government, Chengdu, China.
Vascular. 2023 Apr;31(2):304-311. doi: 10.1177/17085381211060938. Epub 2021 Dec 8.
Hypertension is a major risk factor for coronary, cerebrovascular, and the greatest cause of stroke. Half of stroke events are the result of cerebrovascular atherosclerosis, including carotid plaques. It is of major importance to detect which plaques are vulnerable, even though not yet ruptured. Due to the particularity of the Tibetan population, this study evaluated the elasticity of asymptomatic carotid plaques in Tibetan hypertension patients using shear wave elastography (SWE) and explored associated risk factors.
A total of 91 Tibetan patients were divided into normotension, grade 1-2, and grade 3 hypertension groups based on the level of blood pressure. All subjects underwent common duplex ultrasonic examination and SWE evaluation for carotid plaques. Elasticity of carotid plaque was assessed by Young's modulus.
The final analysis included 126 plaques as representative plaques according to Total Plaque Risk Score. The mean and maximum Young's modulus in the grade 3 hypertension group were smaller, and more plaques with irregularity surface compared with the other two groups ( < 0.05). Multivariate regression analysis showed drinking butter tea (β = -0.220, = 0.009; β = -0.240, = 0.004, respectively) was the independent factor associated with mean and maximum Young's modulus.
SWE is feasible for measurement of Young's modulus of carotid plaques. Plaques in the grade 3 hypertension group were more likely to become vulnerable ones. In hypertension Tibetan patients, drinking butter tea was an independent factor associated with mean and maximum Young's modulus of asymptomatic carotid plaque.
高血压是冠心病、脑血管疾病的主要危险因素，也是中风的最大病因。一半的中风事件是由包括颈动脉斑块在内的脑血管动脉粥样硬化引起的。检测哪些斑块易损，即使尚未破裂，至关重要。鉴于藏族人群的特殊性，本研究采用剪切波弹性成像（SWE）评估藏族高血压患者无症状颈动脉斑块的弹性，并探索相关危险因素。
根据血压水平将91例藏族患者分为正常血压组、1 - 2级高血压组和3级高血压组。所有受试者均接受颈动脉斑块的普通双功超声检查和SWE评估。通过杨氏模量评估颈动脉斑块的弹性。
根据总斑块风险评分，最终分析纳入126个斑块作为代表性斑块。3级高血压组的平均杨氏模量和最大杨氏模量较小，与其他两组相比，表面不规则的斑块更多（P < 0.05）。多因素回归分析显示，喝酥油茶（β分别为 - 0.220，P = 0.009；β为 - 0.240，P = 0.004）是与平均杨氏模量和最大杨氏模量相关的独立因素。
SWE可用于测量颈动脉斑块的杨氏模量。3级高血压组的斑块更易成为易损斑块。在藏族高血压患者中，喝酥油茶是与无症状颈动脉斑块的平均杨氏模量和最大杨氏模量相关的独立因素。
