大动脉弹性与颈动脉粥样斑块的相关性研究

目的：研究正常人及高血压患者颈动脉粥样斑块与大动脉弹性的相关性。方法：应用脉搏波速度（pulse wavevelocity,PWV）自动测量系统测定颈动脉-股动脉PWV作为反映大动脉弹性的参数;B型超声对颈动脉进行扫查,动脉粥样斑块的定义为颈总动脉内膜-中层厚度≥1.3mm。分组情况：①以有无斑块分为颈动脉粥样斑块组与无斑块组。②以收缩压（SBP）≥140mmHg和（或）舒张压（DBP）≥90mmHg分为高血压组和正常血压组。结果：①55例有颈动脉粥样斑块者与140例无斑块者相比,合并颈动脉粥样斑块者年龄、SBP、DBP、动脉脉搏波速度（C-FPWV）、总胆固醇（TCH）、低密度脂蛋白胆固醇（LDL）、高密度脂蛋白胆固醇（HDL）均有显著性差异（均P〈0.01）。Logistic多元回归分析表明,高龄（OR=2.122,P=0.011）、低密度脂蛋白胆固醇（OR=3.546,P=0.015）、C-FPWV（OR=1.074,P=0.033）是颈动脉粥样硬化斑块形成的独立危险因素。②高血压组和正常血压组比较,前者的颈动脉粥样斑块发生率较后者明显增高,而大动脉弹性则明显降低。结论：①年龄、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇增高,高密度脂蛋白胆固醇、大动脉弹性减低与颈动脉粥样斑块形成具有相关性。②高龄、低密度脂蛋白胆固醇增高和大动脉弹性降低在颈动脉粥样斑块的形成过程中起独立作用。③高血压是导致颈动脉粥样斑块形成和大动脉弹性下降的共同危险因素。

Study on the correlation between large artery elasticity and carotid athero-matous plaque

Objective： To evaluate the correlation between the large artery elasticity and carotid atheromatous plaque in healthy people and patients with hypertension. Methods： Automatic pulse wave veloeity（PWV） measurement system and twodimensional echocardiography were applied to examine carotid-femoral PWV and arteria carotis. PWV was used as an index to reflect the large artery elasticity; carotid atheromatous plaque was defined when internal medial thickness （IMT） of carotid artery was beyond 1.3 mm. Croup division： （1）All subjects were divided into carotid athcromatous plaque group and no atheromatous plaque group. （2）All subjects were divided into hypertension group and normal blood pressure group aceording to the SBP≥ 140 mmHg and/or DBP ≥90 mmHg. Results： （1）Compared with 140 patients without atheromatous plaque, 55 patients with atheromatous plaque showed significant difference in age, SBP, PP, DBP, C-FPWV, TCH, LDL, HDL （average P〈0.01）. Furthermore, by logistic regressive analysis it was further found that age （OR=2.122,P=0.011）, LDL （OR=3.546,P=0.035） and C-FPWV （OR =1 .074 , P=0.012） were closely related to the formation of carotid athermanous plaque. （2）Compared with the normal blood pressure group, the incidence rate of carotid atheromatous plaque in hypertension group considerably increased and the large artery elasticity considerably declined. Conclusion： （1）Age, SBP, DBP, TCH, LDL, HDL and large artery elasticity are closely related to the carotid athermanous plaque. （2）Old age, increased LDL and declined large artery elasticity are independent factors in the formation of carotid atheromatous plaque. （3）Hypertension is a common risk factor resulting in the formation of large artery elasticity and declined athermanous plaque.