超声检测心外膜脂肪组织与颈总动脉内中膜厚度在预测冠心病中的诊断价值

目的 探讨心外膜脂肪组织(EAT)与颈总动脉内中膜厚度(CIMT)、冠心病的相关性,进一步分析EAT预测冠心病的意义.方法 入选确诊冠心病需行冠脉造影住院患者160例(其中非冠心病86例,冠心病74例),入院后10d内彩超检测EAT厚度、CIMT厚度,分析EAT厚度与CIMT厚度、冠心病的相关性.结果 相关性分析显示,EAT厚度与CIMT有较好的相关性(r=0.79,P＜0.001);冠心病组EAT、CIMT较非冠心病组明显高[(8.65±1.45)vs (6.30±1.53)mm;(1.17±0.21)vs(0.83±0.19)mm;均P＜0.01)];CIMT≥0.92 mm预测冠心病的敏感度、特异度、Youden指数分别为0.81、0.78、0.59,EAT≥7.24 mm预测冠心病的敏感度、特异度分别为0.84、0.80、0.64.结论 超声检测EAT和CIMT可作为冠心病的预测指标.     

高血压患者血清Semaphorin 3A水平与颈动脉内膜中层厚度的相关性

目的探讨高血压患者血清Semaphorin 3A(Sema 3A)水平与颈动脉内膜中层厚度(CIMT)变化的关系。方法选择2017年1月-2019年9月收治的高血压患者,其中CIMT正常(<0.9 mm)者82例为非增厚组;CIMT增厚(≥0.9 mm)者80例为增厚组;另选同期非高血压健康体检者90名作为对照组。比较各组年龄、总病程、吸烟、降压药用药情况、体质量指数(BMI)、臀围、腰围、收缩压、舒张压、空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸、尿素氮、血清肌酐及Sema 3A的差异。采用Pearson相关性分析Sema 3A及其他各临床指标与CIMT的相关性,通过多元线性回归分析影响CIMT的独立危险因素。结果与对照组比较,非增厚组和增厚组的臀围、腰围、收缩压、舒张压、三酰甘油、总胆固醇、LDL-C、HDL-C、血尿酸、尿素氮、血清肌酐和CIMT差异有统计学意义(P<0.05或P<0.01)。与非增厚组比较,增厚组的腰围、收缩压、舒张压、三酰甘油、LDL-C、血尿酸、血清肌酐、CIMT更高(P<0.05或P<0.01),HDL-C更低(P<0.01)。与对照组比较,非增厚组和增厚组的Sema 3A水平降低[对照组(197.6±14.4)比非增厚组(148.2±14.9)比增厚组(130.4±14.6)mg/L,均P<0.01]。与非增厚组比较,增厚组的Sema 3A水平更低(P<0.05)。Pearson相关性分析显示,高血压患者Sema 3A与CIMT呈负相关(r=-0.422,均P<0.01)。多元线性回归分析显示,Sema 3A是CIMT的保护因素(β=-0.050,P<0.001)。结论高血压患者血清Sema 3A水平与CIMT呈负相关。     

心外膜脂肪组织及颈动脉内中膜厚度与冠心病的相关性研究

目的评价经高频超声测量的心外膜脂肪组织厚度(epicardial adipose tissue,EAT)和颈动脉内中膜厚度(intima-media thickness,IMT)对冠状动脉狭窄程度的预测价值。方法 92例接受冠状动脉血管内超声检查的患者,根据结果分为非冠心病(coronary artery disease,CAD)组25例和CAD组67例,CAD组依据病变程度分为轻、中、重三亚组;经超声测量EAT和IMT,对各组之间的EAT值和颈动脉IMT进行比较,将EAT和颈动脉IMT与CAD进行相关性分析。结果 CAD组与非CAD组比较,EAT和颈动脉IMT值明显升高[(6.54±1.21)mmvs.(4.98±1.33)mm,P<0.05;(1.02±0.20)mm vs.(0.83±0.18)mm,P<0.05];CAD三亚组之间随着病变程度的加重,EAT和颈动脉IMT值逐渐升高。直线相关分析显示EAT(r=0.624,P<0.001)及颈动脉IMT(r=0.392,P<0.001)与冠状动脉面积狭窄率呈直线正相关,Logistic回归分析表明EAT和颈动脉IMT均是CAD的独立危险因子,P值分别是0.028和0.032(P<0.05)。以EAT值≥5.16 mm诊断CAD,诊断敏感性83.6%,特异性68.0%,受试者工作曲线下面积为82.2%(P=0.001);以颈动脉IMT≥0.87 mm预测CAD的敏感性77.6%,特异性64.0%,受试者工作曲线下面积为76.6%(P=0.001)。结论经超声测量EAT和颈动脉IMT可作为评价冠状动脉病变程度简便、可靠和实用的评价指标,可作为CAD患者无创的协同诊断方法。     

超声评价中老年冠心病患者心外膜脂肪层厚度与颈动脉血管弹性的相关性

目的]探究超声评价中老年冠心病(CHD)患者心外膜脂肪层厚度(EAT)与右侧颈总动脉弹性及其内膜中膜厚度(CIMT)的相关性。 [方法]选择2018年2月—2021年6月于南阳市中心医院就诊且经冠状动脉造影(CAG)确诊为CHD的中老年患者(100例)为研究对象,根据病变支数,分为单支(31例)、双支(36例)和三支病变组(33例);另选取同期于南阳市中心医院进行体检的无CHD者(50例)作为对照组。对比分析四组受试者的一般资料以及超声检测参数。通过Pearson分析EAT与右侧颈总动脉弹性、CIMT的相关性。应用受试者工作特征(ROC)曲线分析EAT、右侧颈总动脉弹性和CIMT预测CHD的价值。 [结果]与对照组相比,单支、双支及三支病变组的血管僵硬度(β)、弹性模量(Ep)、脉搏波传导速度(PWV-β)、CIMT和EAT均显著增加(均P＜0.05),顺应性(AC)显著降低(均P＜0.05)。Pearson分析结果显示,EAT与β、Ep、PWV-β及CIMT均呈正相关(P＜0.05),与AC呈负相关(P＜0.05)。ROC曲线分析结果显示,EAT、CIMT以及右侧颈总动脉弹性三者联合预测CHD发生的灵敏度、特异度和Youden指数分别为89%、82%和71%。 [结论]中老年CHD患者的EAT与右侧颈总动脉弹性变化、CIMT均具有良好相关性;EAT与右侧颈总动脉弹性变化以及CIMT联合检测可为临床预测CHD提供较好的依据。     

高血压患者脉压、颈动脉内膜中层厚度和颈股动脉脉搏波传导速度的关系

目的探讨高血压患者脉压、颈动脉内膜中层厚度(CIMT)与颈股动脉脉搏波传导速度(cfPWV)的关系。方法选择2016年1月至2017年6月期间就诊于福建医科大学附属第一医院全科医学和老年科门诊、住院部的原发性高血压患者469例,正常血压者274人。按2×2设计方法,将所有对象分为高血压组及正常血压组,然后以cfPWV 10 m/s为切点值,分别各自分为cfPWV增高组(cfPWV≥10 m/s)和cfPWV正常组(cfPWV<10 m/s)。再次,以CIMT 1.0 mm为切点,分别各自分为CIMT正常组及CIMT增厚组。最后,以年龄65岁为切点,分别各自分为中青年组(<65岁)及老年组(≥65岁)进行分析。测量所有研究对象的血压并计算脉压。应用Pearson相关分析和多元线性回归分析cfPWV的影响因素。结果与正常血压组比较,高血压患者的cfPWV[(9.56±1.93)比(8.46±1.47)m/s]、脉压[(58.6±13.5)比(49.2±10.3)mm Hg]、CIMT[(0.93±0.18)比(0.82±0.17) mm]升高(均P<0.05)。在高血压人群中,cfPWV增高组的脉压[(66.8±14.1)比(54.1±10.7)mm Hg]、CIMT[(0.98±0.16)比(0.90±0.18)mm]高于cfPWV正常组(均P<0.05);老年组的cfPWV[(10.52±2.11)比(9.00±1.55)m/s]、脉压[(66.1±13.7)比(54.1±11.1)mm Hg]、CIMT[(1.02±0.15)比(0.88±0.17)mm]高于中青年组(均P<0.05)。多元线性回归逐步分析结果显示,脉压(β=0.346)、年龄(β=0.345)、心率(β=0.241)、性别(β=-0.142)、空腹血糖(β=0.096)是所有对象cfPWV的相关因素(均P<0.05);分层分析结果显示,无论哪个年龄段及性别,脉压均是cfPWV的相关因素;而CIMT只在中青年人群中是cfPWV的相关因素。结论脉压是高血压患者cfPWV的相关因素,CIMT只是青中年高血压患者cfPWV的相关因素。     

高血压伴左心室肥厚患者心外膜脂肪组织增厚与微量白蛋白尿的关系

目的探讨左心室肥厚高血压患者心外膜脂肪组织(EAT)增厚与微量白蛋白尿的关系。方法选择高血压患者160例,根据超声心动图检查分为左心室肥厚组(肥厚组)和无左心室肥厚组(无肥厚组),每组80例,以同期门诊健康体检者80例为对照组。采用经胸超声心动图检查EAT厚度。采用Pearson相关性分析,用logistic回归分析微量白蛋白尿发生的危险因素,采用ROC曲线分析。结果 3组收缩压、舒张压、微量白蛋白尿、左心房内径(LAD),舒张末期室间隔厚度(IVST)、左心室后壁舒张末期厚度(LVPWT)、左心室质量指数(LVMI)、EAT厚度比较,差异有统计学意义(P0.01)。肥厚组收缩压、舒张压、微量白蛋白尿比例、LAD、IVST、LVPWT、LVMI、EAT厚度显著高于对照组和无肥厚组(P0.05)。肥厚组微量白蛋白尿与年龄(r=0.253,P=0.004),舒张压(r=0.184,P=0.030),LVEF(r=0.278,P=0.000),LVMI(r=0.365,P=0.000),EAT厚度(r=0.506,P=0.000)呈显著正相关。LVMI,EAT厚度是左心室肥厚高血压患者微量白蛋白尿的独立危险因素。EAT厚度预测微量白蛋白尿的最佳临界值为5.8 mm, ROC曲线下面积为0.794(95%CI:0.703～0.892,P0.01)。结论 EAT厚度与左心室肥厚高血压患者微量白蛋白尿呈显著正相关,且是微量白蛋白尿的重要预测因子。     

2型糖尿病患者血清Semaphorin 3a与颈动脉内-中膜厚度的相关性研究

目的探讨T2DM患者血清Semaphorin 3a(Sema3a)与颈动脉内-中膜厚度(CIMT)的关系。方法选取T2DM患者116例,CIMT0.9 mm为正常组(NCIMT组,n=59);CIMT≥0.9 mm为增厚组(ACIMT组,n=57)。同期选取57名健康体检者为对照(NC)组。检测各组临床生化指标。结果与NC组比较,NCIMT组及ACIMT组血清Sema3a升高[(150.00!5.69)vs(124.05±6.93)vs(85.37±4.76)ng/ml,P0.01],NCIMT组高于ACIMT组(P0.05);相关分析显示,血清Sema3a水平与臀围、FPG、尿素、HbA1c呈正相关(r=0.013、0.000、0.032、0.000,P0.05或P0.01);Logistic回归分析显示,年龄、SBP和CIMT增厚呈正相关,血清Sema3a和CIMT增厚呈负相关(P0.05)。结论 T2DM患者血清Sema3a水平增高,是CIMT增厚的保护因素,可能与糖尿病动脉粥样硬化发展过程有关。     

心外膜脂肪厚度与高血压病人肾脏损伤的关系

目的:探讨心外膜脂肪(EAT)厚度与高血压病人肾脏损伤的关系。方法:入选149例高血压病病人,根据超声心动图测量左室肥厚(LVH),将病人分为左室肥厚组(72例)与无左室肥厚组(77例);另选取78名年龄和性别相匹配健康者作为对照组。所有受试者均行经胸超声心动图测量心外膜脂肪厚度,并采集清晨尿样进行微量白蛋白尿(MA)检测。采用Logistic回归分析高血压病人微量白蛋白尿预测因素。结果:左室肥厚组、无左室肥厚组、对照组心外膜脂肪厚度分别为(6.6±1.8)mm、(5.2±1.5)mm、(4.7±1.3)mm,微量白蛋白尿患病率分别为41.7%、 19.5%、3.8%,差异有统计学意义(P<0.001),且左室肥厚组高于其他两组。Pearson相关分析显示,左室肥厚组病人心外膜脂肪厚度与微量白蛋白尿呈正相关(P<0.05);多因素Logistic回归分析显示,心外膜脂肪厚度[OR=3.128,95%CI(2.431,5.163),P<0.001]和左心室质量指数(LVMI)[OR=1.423,95%CI(1.106,2.326),P=0.005]是伴左室肥厚高血压病人...     

经超声测量的内脏脂肪及心外膜脂肪组织厚度对代谢综合征的诊断预测价值

目的评价内脏脂肪厚度(VAT)和心外膜脂肪组织厚度(EAT)对代谢综合征(MS)的诊断预测价值。方法对210例符合入选标准的健康体检对象进行腰围、空腹血生化测定并用超声测量VAT、EAT。根据国际糖尿病联盟MS标准,分为MS组和非MS组,用SPSS12.0软件进行比较分析。结果男女VAT在MS组均高于非MS组(P<0.01),而EAT在男性MS组高于非MS组(P<0.05),女性则两组之间无显著差异;无论男女VAT和EAT均和腰围成正相关。经年龄、性别、腰围调整后,VAT和收缩压、舒张压、甘油三酯、载脂蛋白B、空腹胰岛素、胰岛素抵抗指数成正相关,和胰岛素敏感指数成负相关;EAT和空腹胰岛素、胰岛素抵抗指数成正相关,和胰岛素敏感指数成负相关。经超声测量的VAT、EAT诊断MS的ROC曲线下面积分别为男性为0.74、0.73,女性为0.79、0.63,诊断切点值分别为男性为43.5mm、5.53mm,女性为23.8mm、7.95mm。两种方法ROC曲线下面积比较,无论男女均无显著差异。结论由超声测量的VAT、EAT均可作为内脏型肥胖简便、可靠和实用的评价指标,和MS关系密切,可作为MS患者无创的协同诊断方法之一。     

血清白细胞介素18、胰岛素样生长因子1水平与高血压患者颈动脉内膜中层厚度的相关性

目的探讨血清白细胞介素(IL)-18、胰岛素样生长因子(IGF)-1水平与高血压患者颈动脉内膜中层厚度(CIMT)的相关性。方法选择100例高血压患者(高血压组)及同期行体检健康人群100例(对照组),分析其临床资料,对比两组间基本资料及生化指标,最后进行Spearman相关分析与Logistic多元回归相关分析。结果相比较正常人群,高血压组收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、C反应蛋白(CRP)、IL-18、IGF-1、CIMT明显更高(P0.05)。同时该组内患者进行比较,CIMT增厚组SBP、DBP、FPG、CRP、IL-18、IGF-1、CIMT水平显著高于CIMT正常组(P0.05)。经过Spearman相关性分析,SBP、DBP、FPG、CRP、IL-18、IGF-1与CIMT呈正相关。经过Logistic多元回归分析,IL-18、IGF-1与CIMT有关,是高血压患者CIMT增厚的独立危险因素。结论 IL-18、IGF-1均与高血压患者CIMT密切相关,且均为危险因素。     

The relationship between retinal nerve fiber layer thickness and carotid intima media thickness in patients with type 2 diabetes mellitus

AimsThe aim of the present study was to investigate retinal nerve fiber layer (RNFL) thickness in patients with type 2 diabetes mellitus (T2D) using spectral-domain optical coherence tomography and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT).MethodsThis study included 171 patients with T2D (53.2 ± 8.8 years) and age matched 61 healthy controls (51.9 ± 8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with T2D and controls. The Mann–Whitney U test was used to compare the continuous variables and the Chi-square test was used to compare categorical variables. Spearmanʼs rank correlation test was used for calculation of associations between variables.ResultsThe average RNFL thickness was 84.82 ± 11.22 μm in patients with T2D and 92.35 ± 8.45 μm in healthy controls (p < 0.001). Mean CIMT values were higher in patients with T2D (0.80 ± 0.1 mm) than the healthy subjects (0.72 ± 0.1 mm) (p < 0.001). A significant negative correlation was found between age and all quadrants of RNFL. There was a negative correlation between average RNFL thickness and HbA1c (r = −0.176), uric acid (r = −0.145), CIMT (r = −0.190) and presence of carotid plaque (r = −0.193). The superior RNFL thickness was negatively associated with HbA1c (r = −0.175), CIMT (r = −0.207) and carotid plaque (r = −0.176). There was also an inverse correlation between the inferior RNFL thickness and HbA1c (r = −0.187) and carotid plaque (r = −0.157).ConclusionThinning of RNFL might be associated with atherosclerosis in patients with T2D.     

Choroidal vascularity index and thickness in sarcoidosis

Sarcoidosis is a multisystem granulomatous disease which is observed worldwide. Sarcoidosis is one of the common causes of ocular inflammation. The choroidal vascularity index, defined as the ratio of the luminal area to the total choroidal area, is used as one of the biomarkers for assessing the choroid vascular state. We aimed to compare choroidal vascularity index and thickness measurements between sarcoidosis patients and healthy controls.Thirty-one patients with sarcoidosis and 31 age-gender matched healthy participants were recruited in this cross-sectional and comparative study. Choroidal vascularity index was defined as the ratio of luminal area to total choroidal area after binarization on optical coherence tomography images. Anterior segment examinations included central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle. Spectral-domain optical coherence tomography was used to measure peripapillary retinal nerve fiber layer thickness, choroidal thickness, and retinal vessel caliber.The mean choroidal vascularity index value was 61.6% in sarcoidosis patients and 62.4% in healthy controls (P = .69). The choroidal vascularity index and thickness were significantly correlated in both sarcoidosis (r = 0.41, P = .026) and control groups (r = 0.51, P = .006). Both the sarcoidosis and control groups had similar measured values for central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle (P > .05). Mean retinal nerve fiber layer, retinal arteriole and venule caliber, and choroidal thickness measurements did not differ significantly between the groups (P > .05).Sarcoidosis patients in quiescent period have similar choroidal vascularity index and thickness with healthy controls.     

外周血中性粒细胞计数与颈动脉内膜中层厚度的相关性研究

目的:研究中老年人群中外周血中性粒细胞计数与颈动脉内膜中层厚度(CIMT)的相关性。方法:采用横断面研究,在上海市嘉定区纳入40岁以上居民进行问卷调查,测定其CIMT值和外周血中性粒细胞水平,分析外周血中性粒细胞水平与其两侧CIMT中较大值的相关性。CIMT≥0.7 mm定义为CIMT增厚。结果:纳入受试者共2 496名。中性粒细胞计数平均为(3.59±1.34)×109/L,CIMT平均为(0.58±0.12)mm。随着中性粒细胞计数四分位水平的升高,CIMT增厚的患病率亦随之升高(趋势P=0.000 1)。校正性别、年龄、体质量指数(BMI)、收缩压、餐后2 h血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇后,中性粒细胞计数与CIMT呈显著正相关(β=0.000 511,P=0.001 8)。校正全部因素后,随着中性粒细胞计数水平的增高,CIMT增厚的患病风险逐渐增加,且中性粒细胞计数的第4四分位组(>4.238×109/L)相对于第1四分位组(≤2.671×109/L),CIMT增厚的患病风险增加55%[比值比(OR)=1.55,95%可信区间(CI):1.13~2.14,P=0.000 6]。结论:中老年人群中,中性粒细胞计数升高与CIMT增厚呈显著正相关,中性粒细胞是CIMT的独立危险因素。     

The relation between epicardial fat thickness and metabolic syndrome

Epicardial fat thickness releases numerous markers which play an important role in MetS. In addition, MetS may be associated with oxidative stress, endothelial dysfunction, and atherosclerosis. Various studies highlighted the importance of EFT in line with inflammatory status in cardiovascular diseases. EFT values are linked to abdominal visceral adiposity and subclinical atherosclerosis, which seems to have high capacity of proinflammatory activity. No matter how EFT is measured, it gives clinicians important data for assessing patients inflammatory status     

颈动脉内膜中层厚度与糖尿病血管病变

颈动脉内膜中层厚度是评价糖尿病患者动脉粥样硬化的一项有价值的临床指标,与糖尿病大血管病变及微血管病变联系密切,临床对糖尿病患者进行超声测定颈动脉内膜中层厚度检查可为评价糖尿病血管病变提供客观依据.     

Helical twist controls the thickness of F-actin bundles

In the presence of condensing agents such as nonadsorbing polymer, multivalent counter ions, and specific bundling proteins, chiral biopolymers typically form bundles with a finite thickness, rather than phase-separating into a polymer-rich phase. Although short-range repulsive interactions or geometrical frustrations are thought to force the equilibrium bundle size to be limited, the precise mechanism is yet to be resolved. The importance of the tight control of biopolymer bundle size is illustrated by the ubiquitous cytoskeletal actin filament bundles that are crucial for the proper functioning of cells. Using an in vitro model system, we show that size control relies on a mismatch between the helical structure of individual actin filaments and the geometric packing constraints within bundles. Small rigid actin-binding proteins change the twist of filamentous actin (F-actin) in a concentration-dependent manner, resulting in small, well defined bundle thickness up to approximately 20 filaments, comparable to those found in filopodia. Other F-actin cross-linking proteins can subsequently link these small, well organized bundles into larger structures of several hundred filaments, comparable to those found in, for example, Drosophila bristles. The energetic tradeoff between filament twisting and cross-linker binding within a bundle is suggested as a fundamental mechanism by which cells can precisely adjust bundle size and strength.     

糖尿病视网膜病变黄斑厚度定量分析

目的：研究糖尿病视网膜病变（DR）患者黄斑水肿情况及与荧光渗漏和视功能关系。方法：应用视网膜厚度分析仪（RTA）对18例（25眼）单纯型糖尿病视网膜病变的黄斑区视网膜进行扫描并对其厚度进行定量测量，并与荧光造影结果及视力进行对比分析，结果：RTA检查可清晰的观察到DR患者黄斑区的形态改变；矫正视力负对数之间呈现正相关关系。结论：DR患者黄斑区毛细血管渗漏与组织再吸收失衡是引起黄斑水肿的关键因素，黄斑水肿是导致视力下降的重要原因，RTA检查可为糖尿病黄斑水肿提供客观和精确的诊断依据。