颈动脉和椎-基底动脉粥样硬化与原发性高血压的相关性分析

目的探讨颈动脉和椎-基底动脉粥样硬化病变的发生发展与高血压的关系。方法用超声检测观察组(131例)和对照组(54例)的颈动脉和椎-基底动脉内膜-中层厚度(IMT),同时测定一般临床资料。结果高血压组颈动脉和椎-基底动脉IMT明显大于对照组P<0.01。结论颈动脉和椎-基底动脉粥样硬化严重程度与血压增高有关。提示颈动脉和椎-基底动脉粥样硬化斑块形成可能是原发性高血压发病因素之一。     

颈动脉和椎-基底动脉粥样硬化与原发性高血压的相关性分析

目的 探讨颈动脉和椎-基底动脉粥样硬化病变的发生发展与高血压的关系.方法 用超声检测观察组(131例)和对照组(54例)的颈动脉和椎-基底动脉内膜-中层厚度(IMT),同时测定一般临床资料.结果 高血压组颈动脉和椎-基底动脉IMT明显大于对照组P＜0.01.结论 颈动脉和椎-基底动脉粥样硬化严重程度与血压增高有关.提示颈动脉和椎-基底动脉粥样硬化斑块形成可能是原发性高血压发病因素之一.     

颈动脉内膜-中膜厚度与缺血性脑血管病

颈动脉内膜-中膜厚度（IMT）是指颈动脉血管内膜和中膜之间的垂直距离。IMT增厚是动脉粥样硬化的早期表现。与缺血性脑血管病密切相关。也与多种血管危险因素有关,被认为是反映全身动脉粥样硬化性疾病的良好指标。临床上可借助超声检测颈动脉IMT来反映动脉粥样硬化的发生、发展或消退,并提供临床防治动脉粥样硬化的依据和疗效判断标准。     

颈动脉粥样硬化斑块及内-中膜厚度与冠心病的关系

目的：探讨冠心病患者颈动脉粥样硬化斑块及内-中膜厚度与冠心病的关系。方法：对58例冠心病患者的颈动脉内一中膜厚度及斑块进行超声检测，与35例具有动脉粥样硬化危险因素的患者作对照。结果：冠心病患者的颈动脉内-中膜厚度、斑块指数及斑块检出率明显高于对照组(P均＜0．01)，颈动脉内-中膜厚度与年龄，血总胆固醇、收缩压水平，高血压病呈正相关(r＝0．267-0．532，P＜0.05-0．01)。结论：年龄、甘油三酯、收缩压、高血压病程及斑块指数与颈动脉内-中膜厚度密切相关。     

冠心病患者周围动脉内膜-中层厚度的研究

动脉粥样硬化是一个全身性疾病,本文旨在进一步探讨周围动脉粥样硬化与冠状动脉粥样硬化的关系,尤其是颈动脉窦部(carotid bulb,CB)和股动脉(common femoral artery,CFA)的内膜-中层厚度(intima media thickness,IMT)与冠心病的相关性.     

颈动脉内-中膜厚度和斑块的彩色多普勒超声检测的临床意义

目的　应用高分辨力超声 (HRUS)彩色多普勒血流显像 (CDFI)观察颈动脉内 -中膜厚度 (IMT)和斑块与疾病关系。方法　观察 IMT与年龄、高脂蛋白血症 (HL P)、高血压、冠心病、糖尿病、脑梗塞等疾病的关系。结果　颈动脉内 -中膜厚度和斑块的形成 ,随年龄和病情的加重而加重。结论　应用 HRUS、CDFI观察颈动脉内 -中膜厚度与斑块 ,可判断动脉粥样硬化程度 ,有助于病情的了解     

贝那普利对老年冠心病心绞痛患者肿瘤坏死因子-α和白介素-6的影响

炎症在冠心病的发生、发展和预后过程中起重要的作用。血管紧张素转化酶抑制剂(ACEI)除了具有传统的降血压、抑制心肌及血管增厚作用之外,还有抗动脉粥样硬化(AS)的作用,其抗AS作用可能与抑制某些炎症反应有关。本文观察贝那普利对老年冠心病心绞痛患者血清肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)的影响。     

白细胞介素-18:一种预测冠心病新的重要标记物

动脉粥样硬化斑块的形成不仅由血管内皮被动损伤后脂质浸润引起,而且活动性炎症在动脉粥样硬化形成中可能起到了更为重要的作用。白细胞介素(IL)-18作为一种促炎症因子在细胞因子网络中起着重要作用,它参与了动脉粥样硬化斑块发生、发展乃至破裂的整个过程。1IL-18与冠心病血脂     

γ-谷氨酰转移酶与冠心病研究进展

近年来的研究显示γ-谷氨酰转移酶与心血管疾病密切相关,现就γ-谷氨酰转移酶的分子生物学特征,其致动脉粥样硬化的机制,以及其在冠心病发生、发展中的作用加以综述。     

骨密度对围绝经期女性发生颈动脉粥样硬化及颈动脉斑块易损性的影响研究

目的 探讨骨密度对围绝经期女性发生颈动脉粥样硬化及颈动脉斑块易损性的影响。方法 选取2021年7—10月在河北工程大学附属医院体检中心进行体检的1 000例围绝经期女性,收集受试者临床资料、生化指标、骨密度T值及颈动脉粥样硬化、颈动脉易损斑块发生情况。采用多因素Logistic回归分析探讨围绝经期女性发生颈动脉粥样硬化及颈动脉斑块易损性的影响因素。结果 根据骨密度T值将受试者分为骨量正常组(n=361)、骨量减少组(n=380)和骨质疏松组(n=259)。骨量减少组、骨质疏松组有冠心病史者占比及颈动脉粥样硬化、颈动脉易损斑块发生率高于骨量正常组,骨质疏松组有冠心病史者占比及颈动脉粥样硬化、颈动脉易损斑块发生率高于骨量减少组(P<0.05)。根据是否发生颈动脉粥样硬化将受试者分为颈动脉粥样硬化组(n=667)和无颈动脉粥样硬化组(n=333)。颈动脉粥样硬化组有高血压史、冠心病史者占比高于无颈动脉粥样硬化组,骨密度T值低于无颈动脉粥样硬化组(P<0.05);多因素Logistic回归分析结果显示,冠心病史和骨密度T值是围绝经期女性发生颈动脉粥样硬化的独立影响因素(P<0...     

Ankle brachial pressure index and carotid intima-media thickness as atherosclerosis markers in Japanese diabetics

The aim of this study was to assess the clinical significance of ankle brachial pressure index (ABI) and carotid intima-media thickness (IMT) in Japanese patients with type 2 diabetes. ABI and ultrasonographic carotid IMT measurements were made in 1311 patients and the relationships between ABI, IMT, and cardiovascular diseases were examined. Patients were assigned to one of three groups depending on their ABI index: (i) ABI > or = 1.0; (ii) ABI from > or = 0.9 to < 1.0; and (iii) ABI < 0.9. The odds ratios (ORs) for groups (ii) and (iii) compared with (i) for the prevalence of coronary heart disease (CHD), cerebrovascular disorder (CVD), and carotid atherosclerosis (mean carotid IMT > or = 1.1mm) demonstrated that these conditions were inversely related to ABI. As the combined ABI/carotid IMT score increased, each OR for the prevalence of CHD and CVD increased significantly. This suggests that a lower ABI is associated with generalized atherosclerosis. Measurements of the ABI and carotid IMT might provide a good prognostic indicator, and both should be assessed during screening for atherosclerosis in Japanese patients with type 2 diabetes.     

踝臂指数、颈动脉内中膜厚度对冠状动脉硬化早期预测价值

目的探讨踝臂指数（ABI）与颈动脉内中膜厚度（IMT）的相关性及其对冠心病的预测价值。方法随机选择150例行冠脉造影检查的患者行ABI、IMT测定,调查其年龄、性别、高血压史、糖尿病病史、吸烟史以及身高、体重,计算体重指数,并测量血压,化验血糖、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）和高密度脂蛋白胆固醇（HDL—C）等指标。用SYNTAX积分评价冠状动脉的病变程度,分析在不同病变程度下ABI和IMT之间的相关性。分别用ABI和IMT预测冠心病,并比较两者诊断的可靠程度。结果①以SYNTAX评分判定,ABI除冠脉正常组和轻病变组间差异无统计学意义（p=O．126）外,其余各组间差异均有统计学意义（P〈0．01）,冠状动脉病变越严重,ABI越低。IMT除中、重病变组间差异无统计学意义（P=0．055）外,余各冠状动脉组问差异均有统计学意义（P〈0．05）,冠状动脉病变越严重,IMT值越大。②以SYNTAX积分为协变量,计算ABI与IMT的偏相关系数,两者为负相关（r=一0．499,P=0．000）。SYNTAX积分为分组变量情况下分析ABI和IMT的相关性,显示在冠脉有病变的情况下两者呈负相关。③分别作ABI、IMT预测冠心病的ROC曲线,ABI=0．95,预测冠心病的灵敏度为85．2％,特异度为75．3％;IMT=1．51mm,预测冠心病的灵敏度为77．4％,特异度为64．4％。结论ABI、IMT与冠状动脉硬化程度密切相关,冠脉病变患者ABI越低则IMT越厚。ABI和IMT两种检测方法均对冠状动脉病变程度的评估具有价值,且二者协同互补,可以改善无创检查的敏感性及特异性。ABI和IMT作为非侵入性检测,对筛查无症状冠心病患者及评估冠心病严重程度具有重要意义。     

Relationship of carotid intima-media thickness, pulse wave velocity, and ankle brachial index to the severity of coronary artery atherosclerosis

BACKGROUND: Carotid intima-media thickness (IMT), pulse wave velocity (PWV), and the ankle brachial index (ABI) are widely used noninvasive modalities for evaluating atherosclerosis. HYPOTHESIS: The aim of this study was to determine the relationship of carotid IMT, PWV, and ABI with the severity of coronary artery disease (CAD), expressed as the Gensini score, and the presence of coronary risk factors. METHODS: We examined 205 consecutive patients (mean age 65 +/- 12 years) who were clinically suspected of having CAD and were scheduled to undergo coronary angiography. Carotid intima-media thickness, brachial-ankle PWV (baPWV), and ABI were measured in all subjects before they underwent coronary angiography. RESULTS: Of the 205 patients, 124 patients were diagnosed as having CAD based on the presence of >50% stenosis in a major coronary artery; the remaining 81 patients did not have CAD. A relatively good correlation was obtained between carotid IMT and the Gensini score (R = 0.411, p < 0.0001), whereas baPWV correlated only weakly with the Gensini score (R = 0.203, p = 0.0035), and ABI did not correlate with it. A multiple regression analysis revealed that the Gensini score correlated significantly and independently with age, male gender, and carotid IMT. CONCLUSIONS: Of the three noninvasive methods, carotid IMT may be more useful for determining coronary artery atherosclerosis than baPWV or ABI.     

无创性动脉硬化检测技术对冠心病早期诊断价值的评估

目的：探讨无创性动脉硬化指标颈动脉内中膜厚度（IMT）、踝臂指数（ABI）、脉搏波传导速度（PWV）与冠状动脉粥样硬化程度的相关性以及对冠心病的早期预测价值. 方法：随机选择我院进行冠状动脉造影的133例可疑冠心病患者,进行IMT、ABI、PWV检测.用Gensini积分评价冠状动脉病变程度,采用线性相关系数分析Gensini积分与IMT、ABI和PWV的相关性,观察这些无创性动脉硬化指标对冠心病的早期预测价值. 结果：（1） IMT与Gensini积分明显相关（P=0.000）,IMT数值越大Gensini积分越高;ABI和PWV与Gensini积分无相关性.（2）绘制IMT、ABI和PWV预测冠心病的ROC曲线,IMT的曲线下面积为0.815,预测冠心病的灵敏度为62.7％,特异度为92.9％;ABI和PWV对冠心病的预测价值不显著. 结论：无创性动脉硬化指标IMT与冠状动脉粥样硬化的严重程度有明显的相关性,对冠心病有较好的早期预测价值,而ABI和PWV对冠心病无明显早期预测价值.     

2型糖尿病患者趾臂指数(TBI)与动脉粥样硬化的相关性研究

目的 研究踝臂指数(ABI)正常的2型糖尿病患者趾臂指数(TBI)与动脉粥样硬化的相关性.方法 瑞金医院内分泌代谢病科门诊收集的945例ABI正常(0.9≤ABI＜1.3)患者,根据TBI分为正常组(TBI≥0.6,n=893)和降低组(TBI＜0.6,n=52).分析TBI与颈动脉内中膜厚度(IMT)的相关性,以及TBI降低与动脉粥样硬化之间的关系.结果 TBI降低组的年龄及HbA1C明显高于TBI正常组.TBI与IMT显著负相关,回归系数β=-0.217(P＜0.01).按照TBI＜0.6,0.6≤TBI＜0.8,0.8≤TBI＜1.0,TBI≥1.0分为4组,以TBI等级变量为自变量,是否发生动脉粥样硬化为因变量,进行多元logistic回归分析,TBI降低是动脉粥样硬化的独立危险因素(OR=1.30,95% CI 1.01～1.69,P＜0.05).结论 在2型糖尿病中,TBI的降低是动脉粥样硬化的独立危险因素,有必要在糖尿病患者中早期检测TBI,以便检测到ABI不能发现的动脉硬化及狭窄,及早进行干预,降低糖尿病动脉粥样硬化的风险.     

Impaired lung function and subclinical atherosclerosis. The ARIC Study

An association between reduced pulmonary function and increased risk of atherosclerotic vascular events has been reported. The mechanisms underlying this association are unknown, but are unlikely to be entirely due to smoking given the presence of the association among non-smokers. Few studies have examined the cross-sectional association between subclinical atherosclerosis and pulmonary function. In 14,000 adults in the ARIC Study, we examined the cross-sectional relationship between lung function, measured by the forced expiratory volume at 1 s (FEV₁), and three markers of subclinical atherosclerosis: ankle–brachial index (ABI), carotid intimal–medial thickness (IMT), and presence of carotid plaques. Mean FEV₁ was computed by ABI category, IMT category, or plaque status, in the full cohort and after stratification by smoking status, adjusted for age, gender, race, study center, height, height-squared, smoking, and pack years. Decreased FEV₁ was associated with decreased ABI and increased IMT in the full cohort and in each smoking group. Further adjustment for CVD risk factors did not alter the ABI association, but attenuated the IMT association, eliminating it in never smokers. Plaque was not associated with FEV₁. These findings suggest a complex relationship between FEV₁ and atherosclerotic vascular disease that invites further study.     

糖调节受损患者动脉硬化的临床研究

目的探讨糖尿病(DM)前期及早期患者颈动脉内膜中层厚度(IMT)、颈股动脉脉搏波速度(cfPWV)及踝臂指数(ABI)与动脉硬化发展的关系。方法纳入新诊断的31例2型DM患者(DM组),286例糖调节受损者(IGR组),包括空腹血糖受损(I-IFG)36例和餐后血糖受损(I-IGT)108例,IFG+IGT 142例。自健康体检人群选择年龄、性别与DM组匹配的102例作为健康对照组(CON组)。测量身高、体质量、腰围、臀围、血压、体质量指数(BMI)、胰岛素抵抗指数(ISI)。测量IMT、cfPWV及ABI。比较各组指标,进行相关性分析。结果5组对象的年龄、性别、吸烟史、收缩压、舒张压、TC、TG、HDL-C、LDL-C、脂蛋白A(Apo A)、脂蛋白B(Apo B)值差异无统计学意义(均为P>0.05)。与CON组相比,后4组BMI、腰臀比(W/R)、ISI均明显升高(均为P<0.05),但后4组间差异无统计学意义(均为P>0.05)。与CON组相比,IMT在IFG+IGT、I-IGT和DM组逐渐增厚,cfPWV逐渐增快,ABI明显下降(均为P<0.05),在I-IFG则无此表现(均为P>0.05)。其中I-IGT和DM组较IFG+IGT组IMT增厚更明显(P<0.05),DM组较I-IGT组增厚明显,但未达到统计学差异(P>0.05)。cfPWV在IFG+IGT、I-IGT和DM组逐渐升高,组间比较差异有统计学意义(均为P<0.05)。ABI在IFG+IGT、I-IGT和DM组逐渐下降,组间比较差异有统计学意义,DM组较I-IGT组下降明显,但无统计学意义。相关分析显示,在I-IGT组IMT、cfPWV与ISI呈负相关,与BMI、腰臀比呈正相关,而ABI与ISI呈正相关,与BMI、腰臀比呈负相关。结论IMT、cfPWV和ABI能较好地反映糖尿病临床前期动脉硬化,ISI、BMI、W/R为新诊断DM患者动脉硬化的危险因素。cfPWV较IMT、ABI更敏感,I-IFG可能并非早期动脉硬化的危险因素。     

Association between the ankle-brachial index and carotid intimal medial thickness in the Rancho Bernardo Study

Previous cross-sectional studies have demonstrated significant associations between the ankle-brachial index (ABI) and carotid intimal medial thickness (IMT). In a longitudinal study, 637 participants who had ABI measurements from 1992 to 1994 were tested for carotid IMT an average of 4.8 years later. Mean age was 72.5 years; 60% were women. More than half (51%) were hypertensive, whereas 28% had dyslipidemia, 56% were past or current smokers, and 6% had diabetes. The mean +/- SD ABI and IMT were 1.06 +/- 0.13 and 1.28 +/- 0.44 mm, respectively. Mean age- and gender-adjusted IMTs for the ABI groups of 相似文献   

Close Association between Subclinical Atherosclerosis and Pulmonary Function in Middle-Aged Male Smokers

Aims: Cigarette smoking provokes deleterious influences on cardiovascular and pulmonary systems, although the underlying relationship has not been sufficiently investigated especially in early-stage disease. The present study investigated possible associations between subclinical atherosclerosis and pulmonary function in middle-aged male smokers.Methods: Male smokers undergoing their periodic health check-up were enrolled in this study (n = 3,775, 45 ± 8 years). Pulmonary function was evaluated using spirometry by calculating forced vital capacity (FVC) as a percentage of predicted value (FVC%-predicted), forced expiratory volume in one second (FEV1) as a percentage of predicted value (FEV1%-predicted), and the ratio of FEV1 to FVC (FEV1/FVC). Subclinical atherosclerosis was assessed based on ankle-brachial pressure index (ABI), cardio-ankle vascular index (CAVI), ultrasound examination of the carotid intima-media thickness (IMT), and presence of plaque.Results: Multivariate regression analysis showed that ABI was positively associated with FVC%-predicted and FEV1%-predicted after adjustment for confounders including smoking intensity, while CAVI or carotid IMT was inversely associated with both. Participants with chronic obstructive pulmonary disease (COPD, n = 256) showed reduced ABI and increased CAVI or carotid IMT compared with those without COPD, and participants with carotid plaque had lower pulmonary function than those without plaque. Reduced FEV1/FVC was an independent determinant of carotid plaque and decreased ABI was an independent determinant of COPD, as revealed by logistic regression analysis with the endpoint of carotid plaque presence or a diagnosis of COPD revealed.Conclusions: Middle-aged male smokers showed a close association between subclinical atherosclerosis and pulmonary function, implying that smoking induced-vascular and pulmonary damage are interacting in early-stage disease.     

Arterial wave reflection is associated with severity of extracoronary atherosclerosis in patients with coronary artery disease.

BACKGROUND: Arterial wave reflection is a major determinant of left ventricular function, coronary perfusion and cardiovascular risk. We investigated whether arterial wave reflection may detect atherosclerosis of peripheral arteries in patients with documented coronary artery disease (CAD). METHODS: Radial artery applanation tonometry and pulse wave analysis was performed in 184 patients with documented CAD at coronary angiography; central blood pressures and augmentation index (AI) were measured. Ankle-brachial (ABI) index and intima-media thickness (IMT) were used as indices of atherosclerosis of the lower limbs and the carotid arteries respectively. RESULTS: Patients with abnormal IMT (> 0.7 mm, first tertile) or ABI (< 0.94, first tertile) had higher AI than patients with lower IMT or higher ABI (24 +/- 17 versus 17 +/- 16% and 23 +/- 18 versus 18 +/- 13%, respectively, P < 0.05). In multivariate analysis, increasing AI was associated with age, female gender, heart rate, mean blood pressure, hyperlipidaemia, and use of statins (regression coefficient (beta) = 0.50, beta = 0.15, beta = -0.60, beta = 0.23, beta = 0.16 and beta = -0.14, respectively, P < 0.05). Increasing AI was associated with an adjusted-odds ratio of 1.035 [95% confidence interval (CI), 1.005-1.066], P = 0.02 for an abnormal IMT and of 1.08 (95% CI, 1.024-1.146), P = 0.005 for ABI after adjustment for age, gender, heart rate, height, blood pressure, atherosclerotic risk factors, obesity and medication. No relation was found between AI and Gensini score or for the number of diseased coronary vessels. CONCLUSION: Augmentation index is a marker of extensive extracoronary atherosclerosis in patients with CAD.