颈动脉内膜—中层厚度与胰岛素抵抗的关系

目的 探讨脑梗死患者颈动脉内膜—中层厚度(IMT)与胰岛素抵抗的关系.方法 选择106例脑梗死患者,采用彩色多普勒对颈动脉IMT进行测定,将研究对象分为两组:IMT＜1.0 mm组和IMT≥1.0 mm组.采用放射免疫法测定两组的空腹血胰岛素(FIns)水平,同时检测空腹血糖( FBG)、血脂,计算胰岛素敏感指数(ISI).结果 IMT≥1.0 mm组FIns显著高于IMT＜1.0 mm组,IMT≥1.0mm组ISI较IMT＜1.0 mm组显著降低,比较有差异有统计学意义(P＜0.05).结论 脑梗死患者IMT与胰岛素抵抗存在密切的关系.     

颈动脉内膜-中层厚度与认知功能障碍的关系

目的 探讨脑梗死患者颈动脉内膜-中层厚度（IMT）与认知功能障碍的关系.方法 选择96例脑梗死患者,采用彩色多普勒对颈动脉IMT进行测定,将研究对象分为两组：IMT＜1.0mm组和IMT≥1.0mm组,对两组的神经心理检查结果进行分析.结果 简易智能状态检查量表总分两组间比较无显著性差异.地点定向、时间定向、计算能力、短程记忆、书写能力、结构能力评分,IMT≥1.0mm组得分明显降低,两组间比较有显著性差异（P＜0.05）.结论 脑梗死患者IMT与血管性认知功能障碍存在密切的关系.     

脑梗死患者颈动脉内膜—中膜厚度与LDL、OX—LDL关系的研究

目的 研究脑梗死患者颈动脉粥样硬化的程度,分析低密度脂蛋白（LDL）、氧化低密度脂蛋白（OX-LDL）与颈动脉粥样硬化的关系。方法 B超测定脑梗死组及对照组的颈动脉内膜-中膜厚度（intimal-media thickness;IMT)。测定受试者的LDL、OX-LDL。比较各脑梗死组及对照组的IMT和LDL、OX-LDL。对TMT和LDL、OX-LDL相关分析。结果 伴糖尿病的脑梗死组IMT高于其[经脑梗死组及对照组,IMT与LDL、OX-LDL显著正相关。结论 脑梗死患者的颈动脉粥样硬化程度显著高于对照组;其中伴有糖尿病的脑梗死患者的颈动脉粥样硬化程度尤为明显,LDL、OX-LDL是促进颈动脉粥样硬化的关键因子。     

眼底动脉硬化程度颈动脉内膜中层厚度和脑白质疏松的相关性研究

目的观察眼底血管病变与脑白质疏松的相关性,分析颈动脉内膜中层厚度与脑白质疏松及严重程度的相关性。方法收集我院神经内科病房住院患者或体检者138例,根据磁共振影像,分为脑白质疏松组66例和对照组72例,对所有病人行眼底数码照相分析,应用Scheie法对眼底动脉病变分级,超声测量颈动脉内膜中层厚度,根据Fazekas量表对脑白质疏松程度进行分级,分析对比不同级别的脑白质疏松患者的眼底动脉硬化改变程度、颈动脉内膜中层厚度数值。结果脑白质疏松组与对照组比较,眼底改变程度、颈动脉内膜中层厚度值比较差异有统计学意义(P<0.05)。不同级别脑白质疏松改变,存在眼底动脉硬化程度不同。脑白质疏松轻度改变与中度改变颈动脉内膜中层厚度值比较差异有统计学意义(P<0.05);重度改变与轻、中度改变颈动脉内膜中层厚度值比较差异有统计学意义(P<0.05)。结论眼底改变在一定程度上能够反映脑白质疏松的存在及严重程度,脑白质疏松与颈动脉内膜中层厚度有相关性。     

癫(癎)患者服用丙戊酸钠对颈动脉内膜-中层厚度的影响及其相关因素

目的 探讨癫(癎)患者服用丙戊酸钠(SV)对颈动脉内膜-中层厚度(CA-IMT)的影响及其相关因素.方法 对30例长期单独服用SV治疗的癫(癎)患者(癫(癎)组)及33名健康人(正常对照组),分别用多普勒超声仪检测其左右两侧CA-IMT,并计算左右两侧CA-IMT的平均值.CA-IMT与各可能危险因素的相关性分析采用多元回归分析.结果 癫(癎)组双侧CA-IMT及平均CA-IMT均较正常对照组显著增高(均P<0.001).多元回归分析显示,病程和SV用药时间分别与平均CA-IMT呈正相关(β=0.546,P<0.001;β=0.257,P<0.05).癫(癎)组中病程>3年的患者平均CA-IMT明显高于病程≤3年者(P<0.001);服用SV时间>1年的患者平均CA-IMT稍高于服用SV时间≤1年者,但差异无统计学意义.结论 服用SV治疗的癫(癎)患者平均CA-IMT增高,这可能与病程和SV用药时间有关.     

高敏C反应蛋白水平和颈动脉内膜-中层厚度在动脉粥样硬化性脑梗死合并2型糖尿病患者中的意义

目的探讨高敏C反应蛋白水平和颈动脉内膜-中层厚度在动脉粥样硬化性脑梗死合并2型糖尿病患者中的临床意义。方法回顾分析2013-10—2014-12在我院神经内科就诊的发病72h以内的122例脑梗死患者的临床资料。根据既往是否有2型糖尿病分为糖尿病组及非糖尿病组,应用颈动脉超声检测颈动脉内膜-中层厚度(carotid intima-media thickness,CIMT),入院时同时检测患者高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、空腹血糖(fasting blood glucose,FBG)及糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平。了解CIMT和hs-CRP水平在急性脑梗死合并2型糖尿病患者中的变化,探讨hs-CRP与FBG及HbA1c之间的相关性。结果急性脑梗死合并糖尿病组CIMT和hs-CRP水平均明显高于非糖尿病组,差异有统计学意义(P0.05);急性脑梗死患者FBG与血清hs-CRP水平呈正相关(r=0.479,P0.000 1),HbA1c与血清hs-CRP水平呈正相关(r=0.410,P0.000 1)。结论 CIMT和hs-CRP均可以预测2型糖尿病对脑梗死患者动脉粥样硬化的损害程度。     

干扰素诱导单核因子和干扰素诱导蛋白10水平与颈动脉内膜中膜厚度的相关性

目的探讨干扰素诱导单核因子(MIG)和干扰素诱导的蛋白10(IP-10)水平与颈动脉内膜中膜厚度(IMT)的相关性。方法对研究纳入的164例患者进行临床基线特征测定和随访观察,并记录患者IMT值以及MIG和IP-10血清水平;分析MIG和IP-10血清水平与IMT之间的关系。结果 IMT最大值0. 991±0. 127 mm,平均值0. 796±0. 136 mm。血清MIG和IP-10水平与颈动脉IMT呈显著正相关;血清MIG或IP-10水平与随访期间IMT的变化无显著相关性。当调整混杂因素和药物因素后,血清MIG独立与颈动脉IMT相关(max-IMT:β=0. 198,P=0. 010; mean-IMT:β=0. 186,P=0. 017)。结论血清MIG水平与颈动脉IMT具有独立相关性,这可能预示着血清MIG水平检测在早期动脉粥样硬化诊断方面的潜在临床意义。     

无症状颈动脉内膜-中膜厚度与卒中的关系：美国国际卒中大会的新进展

由美国心脏病协会／美国卒中协会举办的国际卒中大会（International Stroke Conference,ISC）2010年会已于2010年2月23至26日在德克萨斯州的圣安东尼奥召开。会上来自波士顿的Polak教授在其最新的动脉粥样硬化的多种族研究（Multi—Ethnic Study of Atherosclerosis,MESA）中报告了关于颈动脉内膜-中膜厚度（intima—media thickness,IMT）与卒中的关系。     

原发性高血压患者尿酸、血脂水平及颈动脉内膜-中层厚度的临床分析

目的 探讨不同血脂水平的原发性高血压患者中尿酸(UA)、颈动脉内膜-中层厚度(IMT)的改变,及其了解UA在原发性高血压患者中对IMT的预测价值.方法 选择120例住院的原发性高血压患者,其中合并血脂异常者56例,55例体检血压正常者,进行超声波检查,并行UA、血脂等检查.结果 原发性高血压血脂正常组(NC组)与原发性高血压血脂异常组(HC组)IMT、UA、SBP及DBP高于正常对照组(P＜0.05).HC组IMT、UA、TC、LDL-C、TG又高于NC组(P＜0.05),SBP及DBP 2组之间无显著性差异(P＞0.05),3组之间年龄也无显著性差异(P＞0.05).NC组TC、LDL-C、TG、HDL-C与正常对照组相比2组之间无显著性差异(P＞0.05),HC组HDL-C明显低于NC组与健康对照组(P＜0.05),NC组与健康对照组之间HDL-C未见显著性差异(P＞0.05).直线相关分析发现,IMT与UA、LDL-C、TC、SBP、DBP呈正相关(P＜0.05).结论 IMT可早期反映高血压和血脂异常对动脉粥样硬化的促进作用,血清UA水平有助于反映原发性高血压患者IMT的严重程度.     

兔高血压动脉粥样硬化模型颈总动脉内膜厚度与颈动脉弹性传递指数的关联分析

目的：①提出脑动脉弹性储备的新概念,发明脑动脉弹性变化的检测指标--颈动脉弹性传递指数（CETI）. ②将脑动脉弹性储备与脑血管灌注储备力（CCR）和颈总动脉内中膜厚度（CIMT）进行比较,建立脑动脉弹性储备检测系统.方法：新西兰大白兔18只,随机分为高血压＋高血脂组（给予高脂饮食,喂养12周）和对照组（仅供基础饮食）.采用双侧肾动脉狭窄法制作实验兔肾性高血压病模型,采用B超和TCD检测颈内动脉、颈总动脉和基底动脉血流动力学变化,计算CETI,分析CETI、CIMT和CCR之间的相关性.结果：CETI1与CIMT,CETI2与CIMT两变量间的关系符合二次曲线关系,分别为R2=0.84,R=- 0.92,P〈0.05,Y=0.85-1.41t＋1.08t2 和R2=0.72,R=-0.85,P〈0.05,Y=1.35 -3.47t＋4.25t2;CETI3与CIMT,CETI 4与CIMT两变量间的关系符合S曲线关系,分别为R 2=0.54,R=0.73,P〈 0.05,Y=e^（1.11-0.20/t）和R2=0.62,R=0.79, P〈0.05,Y=e^（0.68-0.20/t）;CETI1 、CETI2、CETI3 和CETI4与CCR间各模型的方差分析无统计学意义;CIMT和CCR间各模型的方差分析也无统计学意义.结论：CETI和CIMT之间存在一定相关性,可以用于检测脑动脉硬化改变.CETI和CCR以及CIMT与CCR之间无明显相关性.     

Common carotid artery intima media thickness and post-stroke cognitive impairment

BACKGROUND AND PURPOSE: Acute stroke and other forms of cerebrovascular disease are well-recognized causes of cognitive impairment. Common carotid artery intima media thickness (CCA-IMT) has been associated with certain forms of cerebrovascular disease, but its association with cognitive impairment of vascular origin has not been elucidated. The purpose of this study was to investigate whether CCA-IMT is associated with cognitive impairment 1 year after an acute ischemic stroke. METHODS: A total of 171 consecutive patients with the first ever stroke (mean age 66+/-11.5, 41% female) underwent carotid ultrasonography during hospitalization. Demographic data, vascular risk factors and presenting stroke features were also recorded. One year later, patients' cognitive performance and depression were assessed using the Mini-Mental State Examination (MMSE), and the Montgomery Asberg Depression Rating Scale (MADRS). RESULTS: Cognitive impairment (MMSE score<24) was found in 67 (39%) of the 171 patients. CCA-IMT was significantly associated with cognitive impairment, and this association remained unchanged (OR 1.94; 95% CI 1.19-3.18) after adjustment for demographic data, vascular risk factors, stroke features, other carotid ultrasonography measurements and depression. Older age, low education level, large hemispheric lesions, hyperdense carotid plaques and depression were also independently associated with post-stroke cognitive impairment. CONCLUSIONS: In this study, CCA-IMT was independently associated with cognitive impairment 1 year after an acute ischemic stroke, and thus, it might help with the screening of stroke patients at risk of cognitive impairment.     

Common carotid intima media thickness as a marker of clinical severity in patients with symptomatic extracranial carotid artery stenosis

Objectives

Increased common carotid artery intima-media thickness (CCA-IMT) is a risk factor for ischemic stroke and especially large vessel atherothrombotic infarction. However, the potential association of stroke severity with the intima-media thickening has not been previously studied. We sought to investigate the association between CCA-IMT and clinical severity of ischemic stroke in patients with symptomatic extracranial carotid artery stenosis (SCAS).

Patients and methods

Consecutive patients with acute, first-ever ischemic stroke and SCAS (50%–99%) were prospectively evaluated. All subjects underwent IMT measurements at the far wall of CCA. Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS) on hospital admission and Barthel Ambulatory Index (BI) at hospital discharge.

Results

CCA-IMT was strongly correlated to NIH (Spearman's correlation coefficient: r = 0.546, p < 0.001) and BI (r = −0.450, p < 0.001) in the study population (n = 102). A 0.1 mm increase in CCA-IMT was independently associated with increasing NIHSS-scores on hospital admission (β: 0.510; p < 0.001) and decreasing BI-scores at hospital discharge (β: −0.483; p < 0.001) even after adjustment for demographic characteristics and cardiovascular risk factors. After including baseline stroke severity (NIHSS) in the multivariate linear regressions models evaluating early functional outcome, only NIHSS was independently related to BI (standardized linear regression coefficient: −0.776, p < 0.001), while the initial association between IMT and BI did not retain its statistical significance (β: −0.074, p = 0.276).

Conclusions

Increased CCA-IMT is independently associated with more severe stroke on admission in patients with SCAS.     

Evaluation of serum lipids and carotid artery intima media thickness in epileptic children treated with valproic acid

The aim of this study is to evaluate the carotid artery intima media thickness and serum lipids in pediatric patients with epilepsy treated with valproic acid. The study included 44 pediatric epileptic and 40 healthy children. Intima media thickness of left common carotid artery and fasting lipid profile (total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol) were assessed. Although we did not observe any differences regarding serum lipid profiles, intima media thickness of common carotid artery was significantly higher in epileptic patients treated with valproic acid. We suggest that this increase in intima media thickness of common carotid artery may be due to epilepsy and/or valproic acid treatment.     

颈动脉内-中膜厚度和斑块对颅内动脉狭窄严重程度的预测价值

目的观察缺血性脑血管病(ischemic cerebrovascular disease,ICVD)患者颈动脉内-中膜厚度(com-mon carotid intima media thickness,CCA-IMT)和斑块与颅内动脉狭窄程度的相关性,评价其对颅内动脉狭窄严重程度的预测价值。方法对151例ICVD患者行数字减影全脑血管造影(digital subtraction angiography,DSA),根据DSA结果将患者分为颅内动脉正常、轻、中、重度狭窄组,所有患者在造影前均进行CCA-IMT、斑块检测和常规生化检测。结果中度、重度狭窄组CCA-IMT、斑块分级(carotid plaques score,CPS)较正常组及轻度狭窄组显著增高(P0.05),正常组、轻度狭窄组间及中、重度狭窄组间CCA-IMT、CPS差异无统计学意义(P0.05),CCA-IMT、CPS与颅内动脉狭窄程度呈正相关(P0.01)。CCA-IMT、CPS对中度以上颅内动脉狭窄预测价值的ROC曲线下面积分别为0.755、0.742,CCA-IMT≥1.2mm、CPS=3作为截断值预测中度以上颅内动脉狭窄的阳性似然比最高(分别为6·35、2·74)、有相对高的特异度(分别为93.5%、77.4%)和敏感度(分别为41.3%、62%)。Logistic回归分析显示,在调整了糖尿病、收缩压、舒张压的影响后,CCA-IMT≥1.2mm、CPS=3预测中度以上颅内动脉狭窄的比值比分别为5.603、3.427。结论CCA-IMT、CPS与颅内动脉狭窄程度呈正相关,CCA-IMT≥1.2mm、CPS=3对中度以上颅内动脉狭窄有一定的预测价值。     

Elevated C-reactive protein is associated with an increased intima to media thickness of the common carotid artery.

In this study, we analyzed the relationship between serum C-reactive protein (CRP) and the intima to media thickness (IMT) of the common carotid artery in 411 consecutive neurological inpatients (215 males, mean age 64.1 years). The CRP concentration was determined within 12 h and patients were subdivided according to the CRP level. Patients with an elevated CRP (n = 149) showed a significantly larger IMT [1.05 mm (95% confidence interval (CI) 1.02-1.09) vs. 0.92 mm (95% CI 0.89-0.94)]. Multivariate linear regression analysis revealed that an elevated CRP level, age, pack-years of smoking, body mass index, incidence of diabetes mellitus and ischemic stroke were independently associated with an increased IMT (p < 0.05).     

Increased common carotid artery intima media thickness in adolescent hypertension: results from the Debrecen Hypertension study

BACKGROUND: The aim of the present work was to investigate intima media thickness (IMT) in healthy and in hypertensive adolescents and its influencing factors. METHODS: 103 hypertensive and 58 healthy adolescents were studied. IMT was measured in the common carotid artery using B-mode ultrasonography. Additionally, laboratory parameters (blood glucose, cholesterol, triglycerides, HDL- and LDL-cholesterols) and left ventricular mass indices were obtained. RESULTS: IMT in the common carotid artery was higher in hypertensive adolescents (means +/- SD: 0.55 +/- 0.11 mm) than in healthy control subjects (0.48 +/- 0.08 mm, p < 0.001). Similarly, a higher left ventricular mass index was measured in hypertensive (103.2 +/- 30.6 g/m(2)) than in healthy teenagers (91.1 +/- 25.2 g/m(2), p < 0.001). In general, IMT in adolescents was associated with age, weight, body mass index, left ventricular mass index and average systolic and diastolic blood pressure values of the subjects. By assessing the multivariate association between IMT and other factors, intima-media thickness was only associated with age and left ventricular mass index of the hypertensive subjects and was independent from all the investigated factors in normotensive controls. CONCLUSIONS: Our data suggest an ongoing target-organ damage in adolescent hypertension. These patients need to be subjected to early diagnostic methods, treatment and a regular follow-up, in order to avoid severe clinical manifestations of secondary target-organ damage due to hypertension.     

缺血性脑血管病患者颈动脉内-中膜厚度及斑块分级对颅内外大动脉狭窄的预测价值

目的探讨缺血性脑血管病(ICVD)患者颈动脉内-中膜厚度(IMT)和斑块分级对颅内外大动脉狭窄的预测价值。方法对459例ICVD患者进行颈动脉IMT及斑块检测。采用数字减影血管造影(DSA)对患者颅内外大动脉进行检查。根据有无颅内外大动脉狭窄及狭窄部位将患者分为无动脉狭窄组、颅外动脉狭窄组、颅内动脉狭窄组和颅内外动脉狭窄组;根据狭窄程度又将各狭窄组分轻、中、重度狭窄亚组。比较各组间颈动脉IMT及斑块分级,分析其对颅内外大动脉狭窄的预测价值。结果本组中399例ICVD患者(86.9%)伴颅内外大动脉狭窄。各狭窄组间对应亚组的颈动脉IMT及斑块分级比较,差异均无统计学意义。各狭窄组中,中、重度狭窄亚组颈动脉IMT≥1.07 mm,斑块分级为3,均较无动脉狭窄组及轻度狭窄亚组显著增高(P<0.05~0.01)。ROC分析结果显示,颈动脉IMT增厚及斑块分级增加可预测中、重度颅内外大动脉狭窄(均P<0.01)。将颈动脉IMT≥1.07 mm及斑块分级为3作为预测中、重度颅内外大动脉狭窄的截断值,其敏感度均≥49.17%,特异度均≥81.67%,准确度均≥62.78%。结论颈动脉IMT≥1.07 mm及斑块分级为3对I...