Allan P L, Mowbray P I, Lee A J, Fowkes F G
Department of Radiology, Royal Infirmary of Edinburgh, National Health Service Trust, Scotland.
Stroke. 1997 Feb;28(2):348-53. doi: 10.1161/01.str.28.2.348.
Ultrasonic evaluation of intimamedia thickness (IMT) is one method of assessing the development of early atherosclerosis. This report describes the distribution of IMT within the general population and is one of the first to investigate its association with noninvasively assessed symptomatic and asymptomatic peripheral arterial disease.
Ultrasonic evaluation of IMT was included in the 5-year follow-up examination of participants of the Edinburgh Artery Study. Valid readings of IMT were recorded in 1106 subjects aged 60 to 80 years, and the maximum from the right and left sides of the neck was used in the analysis. Existing symptomatic and asymptomatic peripheral arterial disease and coronary heart disease were also assessed at follow-up using previously validated noninvasive techniques.
IMT increased continuously with age (P < or = .01), and its distribution was positively skewed in both sexes. The results suggest that levels of atherosclerotic development in the common carotid artery are 5 to 10 years more advanced in men than in women. In this population, the overall prevalence of moderate to severe disease was very low (only 1.2% of study participants had IMT values > 2 mm). The presence of symptomatic (intermittent claudication) or asymptomatic (ankle brachial pressure index < or = 0.9) peripheral arterial disease was significantly associated with increased IMT (P < or = .05).
Although the prevalence of advanced atherosclerosis was very low, small changes in IMT were associated with clinically significant development of atherosclerosis in the peripheral arteries. However, further longitudinal studies are needed that standardize measurement techniques and would allow accurate comparisons across studies.
超声评估内膜中层厚度（IMT）是评估早期动脉粥样硬化发展的一种方法。本报告描述了一般人群中IMT的分布情况，并且是首批研究其与非侵入性评估的有症状和无症状外周动脉疾病之间关联的报告之一。
IMT的超声评估纳入了爱丁堡动脉研究参与者的5年随访检查中。在1106名60至80岁的受试者中记录了有效的IMT读数，并在分析中使用了颈部左右两侧的最大值。在随访时还使用先前验证的非侵入性技术评估了现有的有症状和无症状外周动脉疾病以及冠心病。
IMT随年龄持续增加（P≤0.01），其分布在两性中均呈正偏态。结果表明，男性颈总动脉的动脉粥样硬化发展水平比女性早5至10年。在该人群中，中度至重度疾病的总体患病率非常低（只有1.2%的研究参与者IMT值>2mm）。有症状（间歇性跛行）或无症状（踝臂压力指数≤0.9）外周动脉疾病的存在与IMT增加显著相关（P≤0.05）。
尽管晚期动脉粥样硬化的患病率非常低，但IMT的微小变化与外周动脉临床上显著的动脉粥样硬化发展相关。然而，需要进一步的纵向研究来规范测量技术，并允许在不同研究之间进行准确比较。
