颈动脉粥样硬化与冠状动脉病变的相关性研究

目的探讨颈动脉粥样硬化病变的性质、程度及其与冠状动脉病变的关系。方法选择经冠状动脉血管内超声检查的61例患者,根据结果分为冠状动脉粥样硬化性心脏病(冠心病,CHD)组和非CHD组。其中CHD组根据冠状动脉病变狭窄程度,再分成轻、中、重度狭窄三个亚组。所有患者同时用高分辨率超声测量双侧颈总动脉远端的颈动脉内膜-中层厚度(IMT)、斑块,与冠状动脉血管内超声结果进行对比研究,比较CHD各组和非CHD组间颈总动脉IMT、斑块的关系。结果CHD组患者的平均颈总动脉IMT及斑块的发生率均显著高于非CHD组(P<0.05),且随着冠状动脉狭窄程度及病变加重,颈动脉粥样斑块积分也明显增加。结论颈动脉粥样硬化与冠状动脉病变密切相关,可以间接用来判断CHD及其严重程度。     

高频超声在糖尿病颈动脉血管粥样硬化斑块诊断中应用价值分析

目的:分析高频超声在糖尿病颈动脉血管粥样硬化斑块诊断中的应用价值。方法:选取2015年6月~2016年6月于本院接受诊疗的112例糖尿病患者临床资料,予以本组患者颈动脉高频超声检验,依据疾病病程不同,分为对照组(56例)与研究组(56例),病程<8年为对照组,病程≥8年为研究组,比对两组斑块数量与类型以及颈动脉IMT。结果:研究组斑块数量显著多于对照组(P<0.05),斑块类型中软斑块数量最多,扁平斑块数量最少(P<0.05);两组颈动脉分叉部位、颈内动脉主干IMT以及颈总动脉主干对比明显(P<0.05)。结论:高频超声能准确测量患者颈内动脉主干IMT,并清晰显示斑块的类型、分布以及数量,在诊断糖尿病颈动脉血管粥样性硬化斑块中具重要价值。     

蝶骨电极脑电图在颞叶癫痫中的诊断价值

目的探讨颈动脉粥样硬化病变的性质、程度及其与冠状动脉病变的关系。方法选择经冠状动脉血管内超声检查的61例患者，根据结果分为冠状动脉粥样硬化性心脏病（冠心病，CHD）组和非CHD组。其中CHD组根据冠状动脉病变狭窄程度，再分成轻、中、重度狭窄三个亚组。所有患者同时用高分辨率超声测量双侧颈总动脉远端的颈动脉内膜一中层厚度（IMT）、斑块，与冠状动脉血管内超声结果进行对比研究，比较CHD各组和非CHD组间颈总动脉IMT、斑块的关系。结果CHD组患者的平均颈总动脉IMT及斑块的发生率均显著高于非CHD组（P〈0．05），且随着冠状动脉狭窄程度及病变加重，颈动脉粥样斑块积分也明显增加。结论颈动脉粥样硬化与冠状动脉病变密切相关，可以间接用来判断CHD及其严重程度。     

颈动脉内膜-中层增厚和斑块的相关危险因素分析

目的分析颈动脉粥样斑块和内膜-中膜(IMT)增厚的相关危险因素。方法选取2013年1月~2016年4月在本科住院的年龄≤75岁的患者216例,依据颈动脉超声检查分为颈动脉粥样斑块和(或)IMT增厚患者117例(颈动脉异常组)和颈动脉正常患者99例(正常对照组),分析颈动脉粥样斑块和IMT增厚的相关危险因素。结果与正常对照组比较,颈动脉异常组的年龄、肱动脉脉压(PP)、中心动脉收缩压(c SBP)、中心动脉脉压(c PP)、增强压(AP)和增强指数(AIx)显著升高(P<0.05);高血压、冠心病和糖尿病患病率显著增多(P<0.05)。相关性分析显示,颈动脉粥样斑块和IMT增厚与年龄、c SBP、c PP、AP和AIx呈显著正相关(P<0.05),而与肱动脉血压则无明显的相关性。Logistic回归分析显示,年龄、c PP和AP是颈动脉粥样斑块和IMT增厚的独立危险因素。结论中心动脉压与颈动脉粥样斑块形成和IMT增厚具有显著的相关性。     

缺血性脑血管病患者颈部血管超声的临床分析

目的探讨颈部血管超声检查在缺血性脑血管疾病方面的临床应用。方法选择2013年1月至2014年1月在我院神经内科住院的148例缺血性脑血管疾病的患者作为本次临床观察的研究对象，对入选的对象行颈部血管超声检查，分析检查结果。结果148例患者中血管内中膜增厚25例，占16．89％，低回声增厚的有38例，占25．67％，强回声增厚的为29例，占19．59％，混合回声斑块者56例，占37．84％。回顾性分析148例患者的资料，发现148例患者中存在动脉粥样硬化性脑梗死的48例，存在短暂性脑缺血发作的67例，有过脑梗死病史的33例。结论颈部血管超声检查能够准确地提供颈部动脉斑块和血管内膜的详细情况，故颈部血管超声检查可以作为缺血性脑病患者治疗的重要辅助手段和依据。     

同型半胱氨酸水平与老年冠心病患者颈动脉内-中膜厚度的相关性

目的:观察老年冠心病患者血清同型半胱氨酸(Hcy)水平与颈总动脉内-中膜(IMT)厚度的相关性.方法:对72例冠心病老年患者测定血清Hcy水平,并同时做颈动脉超声检查,以颈总动脉IMT有无增厚作为分组标准.其中颈总动脉IMT增厚组48例,非增厚组24例,两组进行性别、年龄、Hey、TC、TG、LDL、HDL、高血压病患病率、2型糖尿病患病率比较,并对颈总动脉IMT增厚组中各危险因素进行多元逐步回归分析.结果:颈总动脉IMT增厚组血清Hcy水平、TC水平、高血压病患病率高于非IMT增厚组,两组差异显著(P<0.05),经多元逐步回归分析后自变量Hcy及LDL对颈动脉IMT增厚有显著影响,为独立危险因素.结论:高Hcy是导致老年冠心病患者颈动脉IMT增厚的一个独立危险因素,与动脉粥样硬化密切相关.     

血府逐瘀胶囊联合厄贝沙坦对高血压患者颈动脉血管重构逆转作用的初步研究

目的高血压患者，观察血府逐瘀胶囊联合厄贝沙坦治疗对高血压患者颈动脉血管重构逆转的影响。方法选取61例新发或未经正规治疗的高血压患者分别单用厄贝沙坦(29例)和联合应用血府逯瘀胶囊(32例)治疗9-12月，另选28名正常人为对照组；采用高频彩色多普勒超声诊断仪测量颈总动脉IMT、LD和IMT／LD。结果高血压患者颈总动脉IMT、ID较正常对照组明显增加，其IMT／ID较正常对照组也增加；厄贝沙坦组和联合用药组血压明显降低，厄贝沙坦组的IMT降低但未致正常，其IMT／ID降低亦不明显，而联合用药组的IMT、IMT／ID较厄贝沙坦组降低明显，其各项指标均接近正常对照组。结论联合应用血府逐瘀胶囊和厄贝沙坦较单用厄贝沙坦能更有效地逆转高血压患者颈动脉的血管重构。     

超声在高血脂患者颈动脉检查中的应用

目的探讨超声在高血脂患者颈动脉检查中的应用价值。方法选取2015年10月至2017年3月收治的64例高血脂患者与64名健康体检者的颈动脉超声诊断进行对照分析;试验组纳入64例高血脂患者,对照组纳入64名健康体检者。对两组临床治疗前后颈动脉超声改变进行对照研究。结果试验组颈动脉内中膜厚度(IMT)增厚阳性率及斑块阳性率明显高于对照组(P<0.05);临床治疗后两组IMT明显减小(P<0.05)。结论超声在高血脂患者的颈动脉检查中有较高的阳性检出率,对颈动脉粥样硬化患者的临床用药有较高的指导价值。     

彩色超声在2型糖尿病下肢血管病变检查中的临床应用

目的：应用彩色多普勒超声诊断仪检测2型糖尿病患者下肢动脉血管病变情况,分析其病变的好发部位及管腔狭窄严重程度的声像图特征。方法：用彩色超声诊断仪,对确诊为2型糖尿病的患者,进行下肢血管超声检查,重点观察股总动脉、股浅动脉、胭动脉、胫前动脉近段、胫后动脉远段、足背动脉的内膜厚度、有无斑块形成及管腔狭窄程度。结果：超声显示64％的患者有不同程度的内膜增厚,其中74％的患者合并斑块形成,24％有不同程度管腔狭窄,2％的患者管腔闭塞。结论：2型糖尿病患者下肢血管发病率较高,彩色超声检查是动态观察下肢动脉血管病变程度和进展情况的有效方法,对糖尿病患者下肢动脉血管病变的早期诊断、预防及治疗可提供影像学依据,且对无临床症状糖尿病患者下肢血管病变的早期诊断、预防、治疗也有重要的临床指导意义。     

2型糖尿病患者下肢动脉病变的超声诊断分析

目的 探讨彩色多普勒超声对2糖尿病患者下肢动脉病变的诊断价值.方法 应用彩色多普勒超声对152例2型糖尿病患者(糖尿病组)、120例非糖尿病患者(对照组)下肢动脉进行检查,将下肢动脉分为股动脉、腘动脉、胫前动脉、胫后动脉及足背动脉5个节段,二维超声评价各个节段管径、内中膜厚度(IMT)、管壁有无斑块和管腔狭窄程度,彩色多普勒显像观察血流充盈情况并测量血流量.分析糖尿病患者下肢动脉斑块的检出率和分布特点,比较两组患者下肢动脉管壁、管腔及血流动力学改变情况.结果 糖尿病组下肢动脉粥样硬化多呈弥漫性,以双侧及多节段性分布,管腔狭窄、闭塞以胫前动脉、足背动脉最常见.糖尿病组下肢动脉管壁粥样硬化斑块、狭窄及闭塞的发生率增高,腘动脉以下血管内径变窄,IMT增厚,血流量减少,与对照组比较,差异均有统计学意义(P＜0.05).结论 彩色多普勒超声可早期准确评估2型糖尿病患者下肢动脉病变发生部位及病变严重程度,在2型糖尿病下肢动脉病变的早期诊断、预防及治疗方面具有重要的临床应用价值.     

高血压患者动态血压负荷及血压节律与颈动脉粥样硬化的关系

目的探讨原发性高血压患者动态血压负荷及血压节律与颈动脉粥样硬化的关系。方法将明确诊断高血压的患者65例行颈动脉超声、动态血压监测检查,询问病史,体检,将上述检查参数、血脂等指标进行比较。结果65例中颈动脉粥样硬化者23例(35.4%),正常者42例(64.6%);颈动脉粥样硬化组与正常组临床资料和生化指标比较差异无统计学意义(P>0.05);颈动脉粥样硬化组24h收缩压/舒张压负荷值(60.1%±16.2%/51.8%±14.2%)、夜间收缩压/舒张压负荷值(72.7%±13.4%/56.5%±12.1%)、血压节律异常者(43.5%)显著高于颈动脉正常组(24h48.2%±12.6%/40.3%±16.7%、夜间45.9%±12.8%/35.2%±11.1%、节律异常31.0%),P<0.01。结论高血压患者动态血压负荷值显著增加及血压节律异常者颈动脉粥样硬化的发生率增多;高血压伴血压节律异常者应常规进行颈动脉检查。     

代谢综合征患者大动脉顺应性与颈动脉内-中膜厚度变化的研究

目的探讨代谢综合征(MS)患者大动脉顺应性及颈动脉内-中膜厚度(IMT)的变化。方法64例MS患者和56例年龄相匹配的正常对照者,测定所有入选者颈动脉-股动脉的脉搏波速度(PWV)、颈动脉IMT,同时检测其身高、体重、腰围、臀围、血压、血糖、血脂水平,并计算体重指数(BMI)、腰臀比(WHR)。结果MS组PWV和颈动脉IMT与对照组比较,差异有统计学意义(P<0.05)。MS组颈动脉IMT与年龄、腰围、收缩压、脉压、总胆固醇、甘油三酯、PWV呈显著正相关(P<0.01),与高密度脂蛋白-胆固醇呈显著负相关(P<0.01);PWV与年龄、收缩压、脉压、体重指数、总胆固醇、甘油三酯、颈动脉IMT、体重呈显著正相关(P<0.05),与高密度脂蛋白-胆固醇呈显著负相关(P<0.01)。结论MS患者PWV及颈动脉IMT均明显升高,已经存在大动脉顺应性的减退;MS患者大动脉顺应性的变化与年龄、血压、肥胖及血脂紊乱有关,且PWV与颈动脉IMT有明显的相关性。     

Determination of endothelial function and early atherosclerotic changes in healthy obese women

The aim of this study was to determine the associations between vascular endothelial function, intima-media thickness (IMT) of the common carotid artery and anthropometric/metabolic parameters in healthy obese women without obesity-related metabolic complications and age-matched healthy lean controls. Twenty-four obese [body mass index (BMI) > 30 kg/m2; age 31.4 +/- 7.4 yr] and 14 lean (BMI < 24 kg/m2; age 30.5 +/- 7.2 yr) women were studied. All of the subjects had normolipemia. Insulin resistance was calculated according to the homeostasis model assessment (HOMA) formula. Endothelial function was measured by flow-mediated dilation (FMD) of the brachial artery. IMT of the common carotid artery was calculated from high-resolution ultrasound imaging of the two common carotid arteries. Obese and lean women were matched with respect to age, smoking status, blood pressure, glucose, insulin concentrations and HOMA. IMT of common carotid artery was significantly higher (0.56 +/- 0.09 vs 0.45 +/- 0.06 mm, p < 0.001) and FMD (percentage of change from baseline) was significantly lower (13.3 +/- 6.5% vs 25.2 +/- 13.9%,p < 0.001) in the obese subjects. Lipid profile, blood pressure, indirect measurement of insulin resistance, leptin concentrations and anthropometric parameters did not predict the FMD or IMT in the obese and lean groups. It is concluded that even in healthy obese women with a normal metabolic profile, deterioration in endothelial function and early atherosclerotic changes are evident compared with healthy lean counterparts. Some undetermined factors in our study other than obesity-related well-known risk factors could be responsible for this observation.     

应用超声评价颈动脉硬化与冠心病的关系

目的 评价颈动脉与冠心病病变程度的关系。方法 对62例不同程度冠脉病变患者及20例正常人进行颈动脉超声检查。结果 冠心病患者颈动脉内-中膜厚度(IMT)较对照组明显增大，随着冠状动脉病变加重，内中膜明显增厚，斑块指数增加，颈动脉斑块以硬斑多见，颈动脉分叉处(BIF)多发。结论 颈动脉硬化与冠状动脉病变关系密切，超声检测颈动脉硬化是一种无创、实时又精确的诊断方法。     

冠心病患者颈动脉硬化与冠状动脉硬化的相关性研究

目的探讨冠心病患者颈动脉粥样硬化与冠状动脉粥样硬化之间的关联性。方法回顾性分析该院200例患者冠状动脉造影结果,非冠心病组100例,冠心病组100例,其中单支病变组32例,二支病变组33例,三支病变组35例,比较冠心病组(不同冠状动脉病变支数三组)与非冠心病组间IMT、斑块积分及Gensini冠状动脉造影评分。结果冠心病组IMT、斑块积分及Gensini评分较非冠心病组明显高(P<0.05);二支病变组与三支病变组IMT、斑块积分及Gensini评分较单支病变组明显高(P<0.05);冠状动脉病变支数与IMT、斑块积分呈正相关性,Gensini冠状动脉造影评分与IMT、斑块积分成正相关性(P<0.05)。结论冠心病患者颈动脉硬化与冠状动脉硬化成显著正相关性,冠状动脉粥样硬化程度随着患者颈动脉粥样硬化程度增强而加重。     

老年2型糖尿病患者颈动脉粥样硬化与血尿酸水平的相关性研究

目的探讨老年2型糖尿病患者颈动脉内膜-中层厚度(IMT)和血尿酸水平的相关性。方法测定178例老年2型糖尿病患者颈动脉IMT、血尿酸和血压、空腹血糖、甘油三酯(TG),按颈动脉IMT将患者分为内膜正常组、内膜增厚组、斑块形成组及管腔狭窄组,比较各组间血尿酸水平。对颈动脉内膜异常患者,采用多元回归分析,统计颈动脉IMT与血压、血尿酸、空腹血糖、TG之间的关系。结果内膜正常组、内膜增厚组、斑块形成组、管腔狭窄组患者血尿酸水平比较差异有统计学意义(P均<0.01)。颈动脉IMT与血尿酸、TG呈现正相关(P均<0.01)。结论老年2型糖尿病患者颈动脉IMT与血尿酸呈正相关,提示老年2型糖尿病患者血尿酸水平可协助诊断冠心病。     

Carotid intima-media thickness measured by ultrasonography: effect of different pharmacotherapies on atherosclerosis progression

The clinical manifestations of arteriosclerosis (cardiovascular, stroke and peripheral artery diseases) represent the leading causes of morbidity and mortality in industrialized countries. The early in vivo diagnosis and follow up of subclinical progression of arteriosclerosis is important for the evaluation of efficient preventive and therapeutic interventions. The carotid artery intima-media thickness (IMT) is a reliable surrogate marker of the arteriosclerosis and could be easily investigated with high resolution B-mode sonography. Due to its good reproducibility, the IMT measurement is optimal for tracking the progression or regression of atherosclerotic disease. The increase of IMT is influenced by numerous vascular risk factors (age, smoking, hypertension, dyslipidemia, alcohol etc.) and positively associated with the incidence of vascular events in the arterial vasculature (stroke, myocardial infarct). Studies with lipid-lowering, antihypertensive, antidiabetic drugs, hormones confirmed, that modifying of vascular risk factors significantly reduces the progression of IMT. It is probable, that reduced progression of IMT is also accompanied with the decrease of future vascular events.     

The Association Between Physical Activity and Subclinical Atherosclerosis: The Multi-Ethnic Study of Atherosclerosis

Prior reports regarding the association between physical activityand subclinical cardiovascular disease have not been consistent.The authors assessed physical activity and walking pace viaquestionnaire among 6,482 US adults aged 45–84 years withoutprior clinical cardiovascular disease participating in the Multi-EthnicStudy of Atherosclerosis from 2000 to 2002. Ankle-brachial index(ABI), coronary artery calcification, and internal and commoncarotid intima-media thickness (IMT) were measured. Metabolicequivalent-hours/week of physical activity were calculated.These data were analyzed by using multivariable linear or relativeprevalence regression in gender-specific strata. After adjustmentfor age, race/ethnicity, clinic site, education, income, andsmoking (model 1), increasing total, moderate + vigorous, andintentional-exercise physical activity were not associated withIMT or coronary artery calcification in either gender. Thesefactors were associated with increased ABI (P < 0.05) inwomen only. Walking pace was associated favorably with commoncarotid IMT, ABI, and coronary artery calcification in men andwith common carotid IMT and ABI in women (all P < 0.05) afteradjustment for model 1 variables. These associations were attenuatedand, for common carotid IMT, no longer significant when lipids,hypertension, diabetes, and body mass index were added to themodel. These data suggest that walking pace is associated withless subclinical atherosclerosis; these associations may bemediated by cardiovascular disease risk factors. atherosclerosis; carotid arteries; coronary vessels; exercise; motor activity; peripheral vascular diseases     

应用血管回声跟踪技术对2型糖尿病患者股动脉血管弹性及血流动力学的研究

目的探讨2型糖尿病患者股动脉血管弹性及下肢血流动力学的变化。方法 应用血管回声跟踪（echo-tracking,ET）技术,采集30例正常人和54例2型糖尿病患者的股动脉的二维超声图像,测量双侧股动脉内中膜厚度（IMT）;应用脉冲多普勒技术（PW）测量股动脉血流阻力指数（RI）、搏动指数（PI）;应用ET技术检测弹性指标β。结果按照IMT是否〈1.0mm分组后显示：糖尿病IMT〈1.0mm组及糖尿病IMT≥1.0mm组的股动脉血流动力学参数RI、PI及弹性指标β均较对照组差异有统计学意义（P〈0.05）;糖尿病IMT≥1.0mm组的股动脉血流动力学参数RI、PI及弹性指标β较糖尿病IMT〈1.0mm组差异有统计学意义（P〈0.05）。结论糖尿病患者下肢动脉在动脉粥样硬化的形态学改变出现之前,血管壁弹性功能已降低,且影响血流动力学,有可能造成外周组织血液供应不良。     

Compliance of the aorta in two diseases affecting vascular elasticity,familial hypercholesterolemia and diabetes: a MRI study

Arterial elasticity changes in familial hypercholesterolemia (FH) and diabetes mellitus (DM) with different but overlapping mechanisms. We compared aortic elasticity between 19 FH patients with the same mutation, 18 type 2 DM patients, and 30 controls, all aged 48 to 64. They underwent aortic magnetic resonance imaging, risk-factor assessment, and carotid and femoral ultrasound measurements. All patients were on adequate cardiovascular medication including statins and had established coronary heart disease (CHD). FH patients had longer-duration CHD (13.3 ± 7.7 years) than did DM patients (5.0 ± 3.1). Aortic compliance in the descending thoracic (DM 0.38 ± 0.14 vs control 0.53 ± 0.19, P = 0.032) and abdominal aorta (DM 0.45 ± 0.20 vs control 0.66 ± 0.25, P = 0.011) was lower in DM patients than in controls, whereas no significant difference existed between FH patients and controls. Carotid and femoral intima-media thickness was greater in FH and DM patients than in controls with no difference between patient groups. Carotid or femoral plaques appeared in 15 (79%) FH and in 10 (56%) DM patients. One control had a femoral plaque. Five FH patients showed stenosis, occlusion or both in carotid arteries. In our opinion, DM patients’ lower compliance reflect mainly arterial media affecting arteriosclerosis, while FH patients’ plaque status and longer duration of CHD suggest more advanced atherosclerosis. The FH patients may therefore be at increased risk for atherothrombotic events. However, due to small patient material, larger confirmatory studies are needed.