血清小而密低密度脂蛋白胆固醇、同型半胱氨酸与颈动脉粥样硬化关系研究

目的探讨血清小而密低密度脂蛋白胆固醇(sdLDL-C),小而密低密度脂蛋白胆固醇与低密度脂蛋白胆固醇之比(sdLDL-C/LDL-C)及同型半胱氨酸(Hcy)与颈动脉硬化的关系,并分析sdLDL-C/LDL-C评价颈动脉斑块的价值。方法选取2017年10月至2019年10月于安徽医科大学合肥第三临床学院心内科住院并行颈动脉彩超检查的200例患者为研究对象,根据颈动脉超声结果分为颈动脉内膜中层厚度(IMT)异常组(n=122)和对照组(n=78)。其中,IMT异常组又分为IMT增厚组(n=30)及颈动脉斑块组(n=92)。Spearman相关分析sdLDL-C与年龄、体质指数(BMI)、LDL-C、高密度脂蛋白胆固醇(HDL-C)、sdLDL-C/LDL-C、超敏C反应蛋白(hs-CRP)、Hcy的相关性;二元Logistic逐步回归方程及有序多分类Logistic回归模型评估颈动脉斑块的独立危险因素。结果IMT异常组血清sdLDL-C、sdLDL-C/LDL-C和Hcy水平均明显高于对照组,差异有统计学意义(P<0.05)。颈动脉斑块组血清sdLDL-C、sdLDL-C/LDL-C和Hcy水平均明显高于IMT增厚组,差异亦均有统计学意义(P<0.001)。Logistic逐步回归分析显示年龄、糖尿病、Hcy、sdLDL-C/LDL-C、sdLDL-C是IMT增厚和颈动脉斑块的独立危险因素。结论在伴有IMT增厚、颈动脉斑块患者中sdLDL-C、sdLDL-C/LDL-C、Hcy水平显著升高。血清sdLDL-C/LDL-C、sdLDL-C、Hcy含量具有颈动脉斑块的预测价值,且是颈动脉粥样硬化的独立危险因素。     

老年人餐后高血糖与颈动脉粥样硬化的相关性

目的探讨老年人餐后高血糖的水平与颈动脉粥样硬化程度的相关性。方法做糖耐量试验(OGTT)入选老年人餐后高血糖123例,应用高频多普勒超声检测老年患者的颈动脉内膜中层厚度(IMT)及斑块程度,测定总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)和低密度脂蛋白胆固醇(LDL-C)。观察分析老年人餐后高血糖与颈动脉IMT及斑块的关系。结果本组老年人住院病例餐后高血糖四分位组分析显示,随分位数增加,老年人颈动脉IMT及斑块严重程度增加。老年人餐后高血糖颈动脉斑块发生率是67.48%。老年人餐后高血糖与颈动脉IMT和斑块严重程度的相关性独立于年龄、性别、血压、TC、TG和LDL-C。结论老年人餐后高血糖水平与颈动脉IMT密切相关。餐后高血糖是老年人颈动脉粥样硬化和斑块形成独立危险因素。     

老年高血压患者血清同型半胱氨酸、超敏C反应蛋白与颈动脉内膜-中层厚度的相关性研究

目的探讨老年高血压患者血清同型半胱氨酸（HCY）与超敏C反应蛋白（hs-CRP）与颈动脉内膜-中层厚度（IMT）的相关性。方法纳入115例老年（年龄≥60岁）高血压患者,依照IMT检查结果分为IMT正常组（n=36）、IMT增厚组（n=38）和斑块形成组（n=41）。分别测定各组血压和血脂及HCY和hs-CRP,并分析其与IMT的相关性。结果 IMT正常组、IMT增厚组及斑块形成组的收缩压（SBP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、HCY、hs-CRP呈升高趋势,差异有统计学意义（P〈0.05）。三组高密度脂蛋白胆固醇（HDL-C）无统计学差异相关分析显示IMT与年龄、SBP、TC、LDL-C、HCY及hs-CRP成正相关。logistic回归分析显示HCY与hs-CRP为IMT影响因素。结论血清HCY水平、hs-CRP浓度与颈动脉粥样硬化程度密切相关,可作为全身心脑血管病的一个危险信号。     

普罗布考和阿托伐他汀联合治疗颈动脉粥样硬化斑块的临床观察

目的研究普罗布考和阿托伐他汀联合应用对颈动脉粥样硬化斑块的治疗作用。方法90例确诊颈动脉粥样硬化斑块的患者随机分成普罗布考和阿托伐他汀联合治疗组(n=30),阿托伐他汀治疗组(n=30),对照组(n=30),共观察6个月。分别于治疗前、治疗后检测3组患者血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)]水平,并进行颈动脉超声检测颈动脉内膜一中膜厚度(intima-media thicknessIMT),及颈动脉内膜粥样硬化斑块,计算斑块面积。结果治疗6个月后普罗布考和阿托伐他汀联合治疗组对TC,TG,LDL降低,颈动脉IMT及颈动脉内膜斑块面积减少均较阿托伐他汀治疗组改善明显(P<0.05)。结论普罗布考和阿托伐他汀联用对颈动脉粥样硬化有显著的治疗作用。     

颈动脉粥样硬化斑块与急性脑梗死患者血脂、血压的相关性研究

目的 探讨颈动脉粥样硬化斑块与急性脑梗死患者血脂、血压的关系.方法 将123例急性脑梗死患者分为脑梗死合并高血压组与脑梗死组,并将51例年龄、性别匹配的健康体检者设为对照组.测量所有患者的血压、血脂,采用彩色多普勒超声检查急性脑梗死患者的颈动脉内膜-中层厚度(IMT)、斑块数量、部位.结果 高血压组颈动脉粥样硬化斑块的发生率达94.9%,发生率和IMT均明显高于脑梗死组和对照组(P＜0.05);斑块最好发的部位为颈总动脉分叉处(BIF),有颈动脉粥样硬化斑块者的血压、胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)均明显高于无粥样硬化斑块者(P＜0.05).结论 颈动脉粥样硬化斑块是脑梗死的重要危险因素之一,而高血压与高血脂是粥样硬化斑块形成的高危因素.     

同型半胱氨酸水平与高血压患者颈动脉粥样硬化的关系研究

目的探讨同型半胱氨酸(Hcy)水平与高血压患者颈动脉粥样硬化的关系。方法选取2013—2016年大理白族自治州人民医院收治的高血压患者1 126例作为观察组,另选取同期体检健康者186例作为对照组;根据颈动脉粥样硬化发生情况将观察组患者分为A组(有颈动脉粥样硬化,n=570)和B组(无颈动脉粥样硬化,n=556)。比较对照组和观察组受试者性别、年龄、Hcy水平、颈动脉粥样硬化发生率,比较A组和B组患者临床特征和实验室检查指标;Hcy水平与高血压患者颈动脉粥样硬化的关系采用多因素Logistic回归分析。结果对照组与观察组受试者性别比较,差异无统计学意义(P0.05);观察组患者年龄、Hcy水平、颈动脉粥样硬化发生率高于对照组(P0.05)。A组与B组患者性别及总胆红素(TBi L)、直接胆红素(DBi L)、间接胆红素(IBi L)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平比较,差异无统计学意义(P0.05);A组与B组患者年龄、体质指数、吸烟史、糖尿病病史、高血压病程、空腹血糖(FBG)及总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、Hcy水平比较,差异有统计学意义(P0.05)。多因素Logistic回归分析结果显示,与Hcy≤10.2μmol/L相比,Hcy 10.3~13.5μmol/L[OR=1.54,94%CI(1.19,1.98)]、13.6~16.2μmol/L[OR=1.60,95%CI(1.26,2.02)]、≥16.3μmol/L[OR=1.65,95%CI(1.23,2.21)]是高血压患者颈动脉粥样硬化的影响因素(P0.05)。结论高血压患者Hcy水平及颈动脉粥样硬化发生率明显升高,且Hcy水平升高是高血压患者颈动脉粥样硬化的影响因素。     

瑞舒伐他汀对H型高血压患者颈动脉粥样斑块的影响

目的:探讨瑞舒伐他汀对H型高血压患者的同型半胱氨酸及颈动脉粥样硬化斑块的影响。方法:随机将80例伴有颈动脉粥样斑块的H型高血压患者分成2组,对照组采用常规降压治疗,观察组在常规降压治疗基础上加用瑞舒伐他汀10mg,每晚1次,治疗12个月。比较两组治疗前后低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)水平,颈动脉内-中膜厚度(IMT)及动脉硬化斑块的变化。结果:治疗12个月后,观察组LDL-C、hs-CRP、Hcy的水平均较治疗前明显下降(P均0.01),颈动脉IMT及斑块明显减小(P均0.01),与对照组相比,也有显著性差异(P均0.05)。结论:瑞舒伐他汀治疗H型高血压,可降低患者hs-CRP、Hcy水平,使颈动脉IMT及斑块减小,延缓和逆转颈动脉粥样硬化的进展。     

乌鲁木齐市哈萨克族、维吾尔族、汉族中老年人群糖化血红蛋白与颈动脉内膜中层厚度的相关性

目的对乌鲁木齐市哈萨克族、维吾尔族、汉族中老年人群糖化血红蛋白(Hb A1c)水平与颈动脉内膜中层厚度(IMT)进行相关性研究。方法选择乌鲁木齐市哈萨克族、维吾尔族、汉族中老年人群共计1 734人,年龄均≥45岁,全部人群需完善调查问卷,检测临床实验指标(包括糖化血红蛋白、空腹血糖、血脂),通过颈动脉超声测量颈动脉IMT。结果使用多变量线性回归模型,在调整了年龄、性别、族别、吸烟、饮酒、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、三酰甘油(TC)、总胆固醇(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)后,发现随着Hb A1c升高颈动脉IMT随之增加(回归系数为0.013,P=0.034),Hb A1c低水平组较高水平组颈动脉IMT约增加0.08 mm,哈萨克族比汉族人群颈动脉IMT约增加0.04 mm,哈萨克族比维吾尔族人群颈动脉IMT约增加0.06 mm。结论在哈萨克族、维吾尔族、汉族中老年人群中,Hb A1c与颈动脉IMT显著相关,且颈动脉IMT有民族差异性。     

不同剂量阿托伐他汀治疗颈动脉粥样硬化斑块的临床观察

目的观察不同剂量阿托伐他汀对老年男性患者颈动脉粥样硬化斑块的消退作用及降脂疗效。方法采用彩色多普勒超声检出颈动脉粥样硬化斑块形成者90例,随机分为两组,分别口服阿托伐他汀10mg、20mg,共16周,观察治疗前后颈动脉内膜中层厚度(IMT)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)的变化。结果阿托伐他汀10mg、20mg均能明显消退颈动脉粥样硬化斑块[IMT10mg组治疗后(1.23 0.19)mm比治疗前(1.48 0.26)mm,P<0.05;20mg组治疗后(1.03 0.2)mm比治疗前(1.46 0.23)mm,P<0.05],降低TC、TG、LDL-C水平(P<0.05),升高HDL-C水平。与10mg阿托伐他汀组比较,20mg阿托伐他汀能更进一步降低TC、LDL-C和升高HDL-C水平(P<0.05)。结论阿托伐他汀可消退颈动脉粥样硬化斑块,有效降低血脂水平。     

高敏C反应蛋白及糖化血红蛋白与高血压脑出血患者颈动脉粥样硬化斑块的相关性

目的探讨高敏C反应蛋白(hs-CRP)及糖化血红蛋白(Hb A1c)与高血压脑出血患者颈动脉粥样硬化斑块的相关性。方法抽取96例高血压脑出血患者作为研究组,根据颈总动脉内膜厚度(IMT)将其分为重度粥样硬化组(n=32)、轻度粥样硬化组(n=33)、单纯脑出血组(n=31),另选取31例同期体检健康者作对照组。对比四组生化指标水平、颈动脉血管病变影响因素及不同类型斑块患者hs-CRP及Hb A1c水平,并分析各指标与IMT的相关性。结果四组空腹血糖水平对比差异无统计学意义(P>0.05),hs-CRP、Hb A1c、IMT、高密度脂蛋白、低密度脂蛋白、总胆固醇、甘油三酯水平对比差异均有统计学意义(P<0.05),其中单纯脑出血组总胆固醇、低密度脂蛋白、高密度脂蛋白、hs-CRP、Hb A1c水平高于对照组(P<0.05);重度粥样硬化组及轻度粥样硬化组hs-CRP、Hb A1c、IMT、高密度脂蛋白、低密度脂蛋白、总胆固醇、甘油三酯水平均高于对照组(P<0.05),且重度粥样硬化组hs-CRP、Hb A1c最高;IMT与hs-CRP、Hb A1c呈正相关;hs-CRP、Hb A1c、IMT均是颈动脉粥样硬化斑块形成的危险因素(P<0.05);软斑患者hs-CRP及Hb A1c水平明显高于溃疡斑、扁平斑、硬斑患者(P<0.05)。结论 hs-CRP及Hb A1c均是导致高血压脑出血患者发生颈动脉粥样硬化斑块的危险因素。     

新疆维吾尔族与汉族老年高血压患者靶器官损害特点分析

目的探讨新疆维吾尔族与汉族老年高血压患者靶器官损害的临床特点。方法选择年龄≥75岁的高血压患者264例,分为汉族组138例,维吾尔族组(维族组)1 26例。检测血压昼夜节律及血压负荷值,动态心电图检测心律失常、心率变异性,颈部多普勒超声检测颈动脉内膜中层厚度,并进行分析比较。结果与汉族组比较,维族组患者24 h平均动脉压、24 h收缩压负荷,昼夜平均收缩压、昼夜平均动脉压、夜间平均收缩压,房性期前收缩、短阵房性心动过速、缺血ST-T改变、平均心率、夜间心率均明显升高(P<0.05,P<0.01);汉族组颈动脉斑块和狭窄检出率明显低于维族组(P<0.05)。结论维吾尔族老年高血压患者血压偏高,易于合并冠心痛和(或)糖尿病,发生代谢紊乱、房性心律失常、心肌缺血及颈动脉斑块形成等靶器官损害的比率高于汉族,同时心率变异性减低。     

Possible risk factors of carotid artery atherosclerosis in the Japanese population: a primary prevention study in non-diabetic subjects

OBJECTIVE: Hyperinsulinemia has been associated with the risk of coronary heart disease, stroke, and renal disease in nondiabetic subjects. However, direct evidence that hyperinsulinemia per se is directly associated with atherosclerosis has been conflicting. The present study was designed to investigate the cross-sectional association of carotid artery atherosclerosis with insulin, independent of well-known cardiovascular risk factors, in nondiabetic subjects. METHODS AND SUBJECTS: Between 1996 and 1997, 1,335 subjects (620 men and 715 women) were recruited from one Japanese community, interviewed, and examined. Clinical measurements in the study included intimal-medial thickness (IMT) of the carotid artery, fasting plasma insulin, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), hemoglobin type HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI). We divided the subjects of both genders into three subgroups according to age (40-49 years of age; 50-59; and 60-69). RESULTS: Using simple regression analysis, we found that IMT was significantly correlated with at least one of TC, LDL-C, HbA1c, SBP, DBP, and BMI in each subgroup. The results of multivariate analysis showed that IMT was independently correlated with TC, HDL-C, LDL-C, SBP and BMI in males and with TC, TG, HDL-C, LDL-C, HbA1c, SBP, DBP, and BMI in females. Insulin levels showed no correlation with IMT in either males or females. CONCLUSION: Fasting hyperinsulinemia does not appear to be correlated with carotid artery atherosclerosis based on the present cross-sectional results.     

原发性高血压及相关危险因素与颈动脉内-中膜厚度的相关性研究

目的探讨原发性高血压(高血压)及相关危险因素与颈动脉内-中膜厚度(intima-media thickness,IMT)的相关性。方法本文收集了2007年6月至2007年12月在贵阳医学院诊治且病历资料较完整的186例高血压患者,按血压水平由低至高分成3组:高血压1级组50例;高血压2级组56例;高血压3级组80例。另外,选择门诊健康体检者50名作为对照组。收集研究对象的一般情况、血生化指标及双侧颈总动脉IMT及斑块的超声测量结果。结果高血压各组的颈动脉IMT,颈动脉斑块发生率明显高于对照组,并随血压等级增加而增加,方差分析及q检验显示差异有统计学意义(P0.05)。Logistic回归分析显示,年龄、男性、吸烟、总胆固醇及低密度脂蛋白胆固醇是颈动脉IMT增加的独立危险因素(P0.05),而脂蛋白(a)、尿酸、肌酐与颈动脉IMT无明显相关性(P0.05)。结论高血压可使颈动脉IMT增加,其程度和颈动脉斑块发生率均随血压分级增高而增加;年龄、男性、吸烟、总胆固醇及低密度脂蛋白胆固醇是颈动脉IMT增加的独立危险因素;脂蛋白(a)、肌酐、尿酸与颈动脉IMT无明显相关性。     

牙周病患者颈动脉内膜中层厚度与可溶性细胞黏附分子的相关性研究

目的探讨牙周病患者颈动脉内膜中层厚度(IMT)与可溶性细胞黏附分子1(sICAM-1)的相关性。方法选择牙周病患者40例(牙周病组),另选择健康体检者40例(对照组),测定2组空腹血糖、空腹胰岛素(FINS)、TC、TG、HDL-C、LDL-C、sICAM-1水平,采用彩色B超测量IMT,分析影响牙周病患者IMT的可能因素。结果牙周病组患者TC、TG、FINS、sICAM-1及IMT明显高于对照组,差异有统计学意义(P<0.05,P<0.01)。牙周病患者IMT与年龄、TC、TG、LDL-C、sICAM-1、体重指数呈正相关(P<0.05,P<0.01)。结论牙周病患者血清sICAM-1水平升高,与动脉粥样硬化的发生有关。     

Descriptive study of the relationship between the subclinical carotid disease and biomarkers,carotid femoral pulse wave velocity in patients with hypertension

Background: Carotid intima-media thickness (cIMT) is a significant early prediction signal for preclinical atherosclerosis. Plasma homocysteine (Hcy) level is an independent risk factor for cardiovascular diseases. Pulse wave velocity (PWV), an index of arterial stiffness (AS), has showed its value in the evaluation of AS in vascular-related diseases. The data regarding the relationships between cIMT and other indices of vascular damage are limited and partly controversial. We aim to investigate the relationships between cIMT and other indices of vascular damage such as Hcy and carotid femoral PWV (CF-PWV). Methods: In total,1188 (male/female 514/674) subjects with hypertension from Vascular Medicine of Peking University Shougang Hospital were enrolled into our study. The patients with hypertension were measured bilateral cIMT by B-mode ultrasound and measured plasma levels of Hcy, total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), C-reactive protein (CRP), glucose, and other biomarkers. Plaques were detected in 78% of the study patients. Plasma Hcy (p < 0.001), CRP (p <  0.001), LDL (p < 0.001), HDL (p = 0.008), TC levels (p < 0.001), and CF-PWP (p < 0.001) were significantly greater in hypertensive patients with carotid plaques than patients without. The carotid plaque detection rate (p < 0.001) and bilvertebral artery max velocity (p < 0.05) were significantly different in quartiles of plasma Hcy levels. R-IMT correlated significantly with HCY, high sensitive CRP (hs-CRP), CF-PWV, and R-vertebral artery intimal diameter. Age (p < 0.001) and CF-PWV (p < 0.05) predicted the presence of carotid plaques independently in the logistic regression. However, Hcy did not independently predict the presence of carotid plaques in the logistic regression. Conclusion: Increased carotid femoral PWV and elevated plasma Hcy levels are associated with subclinical carotid disease in hypertensive patients. CF-PWV independently predicted subclinical carotid plaque in the patients with hypertensive. While, there is insufficient evidence for Hcy in predicting plaque incidence.     

维汉两族患者的胰岛素敏感指数与冠状动脉粥样硬化程度的关系

目的：探讨维汉两族患者胰岛素敏感指数（ISI）与冠状动脉粥样硬化程度的关系。方法：选择125例冠心病患者,其中维吾尔族59例,汉族66例;稳定性心绞痛42例、不稳定性心绞痛52例、陈旧性心肌梗死31例、2型糖尿病患者53例、高血压病患者35例,收集患者的相关病史（年龄、人体质量指数）,进行实验室检查（血脂,空腹血糖、空腹胰岛素等）,及冠状动脉造影评价冠脉病变程度。计算ISI,并分析其与冠状动脉粥样硬化病变程度的关系。结果：ISI在两族人群中均与冠状动脉粥样硬化程度呈负相关（汉族：r=-0．71,P=0．03,维族：r=-0．52,P=0．04）,在汉族患者中与人体质量指数呈负相关,与糖化血红蛋白（（HbAlc））及低密度脂蛋白-胆固醇（LDL-c）呈负相关（r=-0．45、-0．68、-0．55,P均〈0．05）;在维吾尔族患者中与高密度脂蛋白-胆固醇（HDL—C）正相关（r=0．67,P〈0．01）,与（HbAlc）、LDL-C、脂蛋白a呈负相关（r=-0．47、-0．35、-0．42,P〈0．05）。结论：胰岛素抵抗参与并促进冠状动脉粥样硬化斑块的形成及发展,控制维汉两族冠心病患者体重,降低血糖,LDL-C等水平均可减少胰岛素抵抗,预防冠心病的发生、发展。     

新疆维吾尔自治区汉、维吾尔和哈萨克族人群颈动脉内中膜厚度的流行病学调查

目的 了解新疆维吾尔自治区汉、维吾尔和哈萨克族35岁及以上人群颈动脉内中膜厚度(intima-media thickness,IMT)及其相关危险因素.方法 采用整群随机抽样方法抽取新疆维吾尔自治区汉、维吾尔和哈萨克族35岁及以上居民进行颈动脉IMT及其相关危险因素的横断面调查.结果 新疆维吾尔自治区35岁及以上人群的颈动脉IMT汉族为(0.0761±0.0283)cm,维吾尔族为(0.0663±0.0262)cm,哈萨克族为(0.0781±0.0274)cm,不同民族之间的IMT差异均有统计学意义(均P＜0.05).汉族颈动脉IMT男性为(0.0807±0.0288)cm,女性为(0.0717±0.0270)cm(P＜0.01);维吾尔族颈动脉IMT男性为(0.0706±0.0270)cm,女性为(0.0633±0.0252)cm(P＜0.01);哈萨克族颈动脉IMT男性为(0.0794±0.0280)cm,女性为(0.0768±0.0268)cm(P＜0.01).简单线性相关分析显示,新疆维吾尔自治区汉、维吾尔和哈萨克族人群年龄、收缩压、舒张压、空腹血糖、总胆固醇、踝臂指数与颈动脉IMT相关(r值分别为0.176,0.168,0.167,0.053,0.097和0.067,均P＜0.05).结论 新疆维吾尔自治区哈萨克族的颈动脉IMT大于汉族和维吾尔族.IMT与年龄、收缩压、舒张压、空腹血糖、总胆固醇、踝臂指数相关.

Abstract：

Objective To investigate carotid artery intima-media thickness (IMT) and the correlated risk factors in Han, Uygur, Hazakh residents over 35 years old of Xinjiang Uygur autonomous region. Method Cross-sectional and cluster sampling random selected method was carried out for residents over 35 years old in Han, Uygur, Hazakh population of Xinjiang to investigate IMT and correlated risk factors. Results IMT of Han, Uygur, Hazakh residents over 35 years old of Xinjiang Uygur autonomous region was (0. 0761 ± 0. 0283 ) cm, (0. 0663 ± 0. 0262) cm, and (0. 0781 ± 0. 0274 ) cm, respectively. There were significantly difference between various nationality( all P ＜0. 05 ). IMT was thicker in male Han people than in female Han people [(0. 0807 ± 0. 0288 )cm vs. (0. 0717 ± 0. 0270 ) cm, P ＜ 0. 01] and in male Uygur than in female Uygnr residents [(0. 0706 ±0. 0270)cm vs. (0. 0633 ±0. 0252)cm, P ＜0. 01]and in male Hazakh and female Hazakh residents [(0. 0794 ± 0. 0280) cm vs. (0. 0768 ± 0. 0268 ) cm, P ＜ 0. 01].Linear correlation analysis showed that age ( r = 0. 176, P ＜ 0. 05 ), systolic blood pressure ( r = 0. 168, P ＜ 0. 05 ), diastolic blood pressure ( r = 0. 167, P ＜ 0. 05 ), fasting blood glucose ( r = 0. 053, P ＜ 0. 05 ), total cholesterol(r = 0.097,P ＜ 0.05) and ankle brachial index (r = 0.067, P ＜ 0.05) were significantly correlated with IMT. Conclusions Our results showed that IMT was thicker in Hazakh residents than in Han and Uygnr residents. IMT was closely related to known cardiovascular risk factors including age,systolic blood pressure,diastolic blood pressure,fasting blood glucose, total cholesterol and ankle brachial index level.     

老年原发性高血压患者颈动脉内膜中层厚度与心血管危险因素相关性分析

目的分析老年原发性高血压患者预动脉内膜中层厚度（IMT）与心血管危险因素的相关性方法对82例老年原发性高血压患者行颔动脉超声测定IMT,同时检测患者血压乐、血三酰甘油（TG）、总胆固醇（TC）、高密度胆固醇（HDL—C）、低密度胆同醇（LDL—C）、空腹糖（FBG）及超敏C反应蛋白（hsCRP）。按照颈动脉IMT厚度分为IMT增厚组和IMT正常组,并对两组年龄、病程、血压值及生化指标等进行比较分析结果IMT增厚组较IMT正常组年龄较大,高血压病程较长,收缩压（SBP）、TC、LDL—C、FBG、hsCRP较高,HDL—C较低;随着IMT的增厚,高LDL—C、高FBG、高hsCRP的检出率增加。结论老年原发性高血压患者预动脉IMT与心血管危险因素聚集有显著的相关性。     

Association of Systolic Blood Pressure and Pulse Pressure with Carotid Intima Thickness in Elderly Japanese Patients

Many studies have demonstrated that increased carotid intima-media thickness (IMT) is related to future cardiovascular events and is influenced by cardiovascular risk factors such as sex, hypertension, diabetes, and hypercholesterolemia. Although aging is a well-known risk factor for an increase in carotid IMT, few studies have investigated which factors influence carotid IMT in the very elderly. In the present study, we investigated the relationship of pulse pressure (PP), blood pressure (BP), and its variability (six consecutive visits) with carotid IMT among 240 high-risk elderly in whom risk factors were managed clinically (average age was 79 ± 5 years). In the simple correlation, mean systolic BP (SBP) had a positive correlation with IMT and max IMT (P = .012 and P = .045), as did PP (P = .018 and P = .004), but did not diastolic BP or standard deviation of BP and coefficient of variation of BP. In multiple regression analyses, mean SBP and mean PP were each determinants of both IMT and max IMT, when each parameter was added separately to the regression model. We concluded that high SBP and wide PP still have an influence on increased carotid IMT in the very elderly Japanese patients.