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59至71岁人群颈动脉扩张的相关因素:EVA研究

Factors of carotid arterial enlargement in a population aged 59 to 71 years: the EVA study.

作者信息

Bonithon-Kopp C, Touboul P J, Berr C, Magne C, Ducimetière P

机构信息

INSERM U 248, Hopital Broussais, Paris, France.

出版信息

Stroke. 1996 Apr;27(4):654-60. doi: 10.1161/01.str.27.4.654.

Abstract

BACKGROUND AND PURPOSE

Factors of carotid arterial enlargement are not well known in general populations. The purpose of this study was to assess the cross-sectional associations of arterial wall lesions and cardiovascular risk factors with carotid lumen diameter in elderly subjects.

METHODS

B-mode ultrasound examinations of the carotid arteries and risk factor assessment were made in 1272 participants in the EVA (Etude sur le vieillissement artériel) Study, a longitudinal study designed to evaluate vascular and cognitive aging in men and women aged 59 to 71 years. Ultrasound examinations included measurements of intima-media thickness (IMT) and interadventitial and lumen diameters of the common carotid arteries and quantification of atherosclerotic plaques in extracranial carotid arteries.

RESULTS

Men showed greater IMT interadventitial and lumen diameters of the common carotid arteries than did women. In both sexes, common IMT and plaque score were positively associated with common interadventitial and lumen diameters. Stepwise multiple regression analysis showed that male sex, body height and weight, common IMT, plaque score, systolic blood pressure, and alcohol consumption were positively and independently related to lumen diameter. On the other hand, an independent negative association was observed between low density lipoprotein cholesterol and lumen diameter.

CONCLUSIONS

In 59- to 71-year-old subjects, increased IMT and atherosclerotic plaques were accompanied by an increase in lumen diameter of the common carotid arteries, indicating an overcompensation. Luminal enlargement observed with several risk factors and with high blood pressure in particular might be partially counteracted by high lipid levels.

摘要

背景与目的

一般人群中颈动脉扩张的因素尚不明确。本研究旨在评估老年受试者动脉壁病变及心血管危险因素与颈动脉管腔直径之间的横断面关联。

方法

对1272名参与EVA(动脉老化研究)研究的受试者进行了颈动脉B型超声检查及危险因素评估。该纵向研究旨在评估59至71岁男性和女性的血管及认知老化情况。超声检查包括测量颈总动脉的内膜中层厚度(IMT)、外膜间径及管腔直径,以及对颅外颈动脉粥样硬化斑块进行定量分析。

结果

男性颈总动脉的IMT、外膜间径及管腔直径均大于女性。在两性中,颈总动脉的IMT及斑块评分均与外膜间径及管腔直径呈正相关。逐步多元回归分析显示,男性、身高、体重、颈总动脉IMT、斑块评分、收缩压及饮酒量与管腔直径呈正相关且独立相关。另一方面,观察到低密度脂蛋白胆固醇与管腔直径之间存在独立的负相关。

结论

在59至71岁的受试者中,IMT增加及动脉粥样硬化斑块形成伴随着颈总动脉管腔直径增加,提示存在过度代偿。观察到的多种危险因素尤其是高血压导致的管腔扩大可能会被高血脂水平部分抵消。

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