Yang Yujia, Hua Yang, Jia Lingyun
Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China.
Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China.
J Ultrasound Med. 2025 May;44(5):915-925. doi: 10.1002/jum.16651. Epub 2025 Jan 21.
This study analyzed carotid artery remodeling characteristics in early carotid atherosclerosis (ECAS).
The 1021 participants were evaluated using ultrasonography and categorized into three groups: Group A, 391 participants with increased intima-media thickness (IMT); Group B, 300 participants with atherosclerotic plaque only on the carotid bulb (CB); and the control group (330 participants). The ratios of the diameters in the CB to those in the common carotid artery (D) and internal carotid artery (D) were defined as carotid index1 (CI) and 2 (CI).
Group A had a higher D, D, and CI than the controls (P < .05). Group B had a smaller D, CI, and CI than Group A, and higher D and smaller CI than the controls (P < .05). Logistic regression showed that CI was a positive influencing factor for increased IMT (OR: 3.42, 95% CI: 1.74-6.70, P < .001), and CI was a negative independent factor for CB plaque formation (OR: 0.11, 95% CI: 0.04-0.28, P < .001). Multiple linear regression showed that only in Group B, the vessel side had a significant influence on CI (β = 0.055, P < .05), while age, sex, body mass index, and cerebrovascular risk factors had no significant correlation with CI.
The CB and common carotid artery showed positive remodeling with increased IMT, however, the CB showed negative remodeling with plaque formation. CI changes were consistent with CB remodeling. CI was an independent influencing factor for ECAS, and it was only affected by vessel side, providing an objective predictive parameter for ECAS.
本研究分析了早期颈动脉粥样硬化(ECAS)患者的颈动脉重塑特征。
对1021名参与者进行超声检查,并将其分为三组:A组,391名内膜中层厚度(IMT)增加的参与者;B组,300名仅在颈动脉窦(CB)有动脉粥样硬化斑块的参与者;以及对照组(330名参与者)。将CB处的直径与颈总动脉(D)和颈内动脉(D)处的直径之比定义为颈动脉指数1(CI)和2(CI)。
A组的D、D和CI高于对照组(P < 0.05)。B组的D、CI和CI小于A组,D高于对照组,CI小于对照组(P < 0.05)。逻辑回归显示,CI是IMT增加的正性影响因素(OR:3.42,95%CI:1.74 - 6.70,P < 0.001),CI是CB斑块形成的负性独立因素(OR:0.11,95%CI:0.04 - 0.28,P < 0.001)。多元线性回归显示,仅在B组中,血管侧对CI有显著影响(β = 0.055,P < 0.05),而年龄、性别、体重指数和脑血管危险因素与CI无显著相关性。
CB和颈总动脉在IMT增加时表现为正性重塑,然而,CB在斑块形成时表现为负性重塑。CI变化与CB重塑一致。CI是ECAS的独立影响因素,且仅受血管侧影响,为ECAS提供了一个客观的预测参数。