Tracking of Noninvasive Ultrasound Measurements of Subclinical Atherosclerosis in Adulthood: Findings from the Cardiovascular Risk in Young Finns Study

We examined tracking of ultrasound measurements of vascular structure and function in adulthood using data collected in the 2001 and 2007 follow-ups of Cardiovascular Risk in Young Finns Study. B-mode ultrasound measures of carotid artery intima-media thickness (IMT), carotid artery distensibility (CDist) and brachial artery flow-mediated dilatation (FMD) was obtained on 1809 apparently healthy Finnish adults aged 24 to 39 years in 2001 (1014 females; 795 males). Significant 6-year tracking was observed for IMT (males, r = 0.56; females, r = 0.46), CDist (males, r = 0.35; females, r = 0.36) and FMD (males, r = 0.23; females, r = 0.20). Subjects with 10-year risk of CVD (according to the SCORE risk score) above sex-specific median had improved IMT (r = 0.44; r = 0.57, p = 0.0001) and CDist (r = 0.31; r = 0.40, p = 0.03) tracking compared with those below median. Body mass index (BMI) ≥ 30 kg/m² decreased tracking of CDist (r = 0.36; r = 0.19, p = 0.01). In conclusion, ultrasound measurements tracked low to moderate over 6-years and was influenced by cardiovascular disease (CVD) risk factor status. (E-mail: juho.raiko@utu.fi)     

老年高血压病患者动态血压与颈动脉粥样硬化的关系

目的:研究老年原发性高血压(EH)患者24h动态血压(ABPM)与颈动脉粥样硬化(CAS)的关系。方法:采用袖带式动态血压仪监测100例老年EH患者的ABPM,彩色超声测量颈动脉内-中膜厚度,有CAS者为研究组,无CAS者为对照组,研究ABPM参数与CAS之间的关系。结果:老年EH患者血压控制达标后,血压曲线异常呈非杓型者明显增多,占66.0%;两组24h平均收缩压和舒张压之间无明显差异,但研究组的动态脉压,日间脉压和夜间脉压[分别是(53.5 6.8,53.7 7.5和53.6 8.3)mmHg]均较对照组[分别是(48.9 8.1,48.1 10.8和48.5 9.8)mmHg]增大,有显著性差异(P=0.005)。CAS的总发生率是64.0%,而杓型组中CAS的发生率是53.0%,非杓型组是68.0%,两组间无显著性差异(P>0.05)。结论:老年EH患者血压控制达标后,脉压(PP)增大与CAS的发生密切相关;血压昼夜节律异常呈非杓型者明显增多。     

Endothelial Function Evaluated by Flow-Mediated Dilatation in Pediatric Vascular Disease

The endothelial function of children with and without vascular disease, consisting of 41 controls, 24 with Kawasaki disease (KD), and 46 with diabetes mellitus (DM), was examined. Age at examination ranged from 3 to 23 years (mean, 12.0 ± 4.7). The flow-mediated dilatation (FMD) and intima-media complex in the common carotid artery were measured. In controls age at examination was not associated with FMD or intima-media complex. FMD significantly decreased in children with KD and DM compared with the control group (control vs KD or DM: 11.7 ± 14.7 vs 3.0 ± 11.0 or 6.4 ± 8.5%, respectively; p < 0.05). However, there was no significant difference for intima-media complex among the groups. Furthermore, FMD in KD patients with coronary arterial aneurysm was lower than that in KD patients without aneurysm (-0.5 ± 9.2 vs 8.3 ± 9.1%, p < 0.05). In DM patients, FMD in the high HbA1c group (HbA1c = 7%) was lower than that in the normal HbA1c group (HbA1c < 7%) (4.8 ± 8.1 vs 11.4 ± 7.8%, p < 0.05). In conclusion, FMD detected endothelial impairment in children with KD or type 1 DM regardless of overt vascular complications, and FMD impairment occurs prior to intima-media complex thickening. By measuring both FMD and intima-media complex, useful information for predicting vascular complications may be obtained.     

颈动脉超声在心血管疾病中的应用

目前,心血管疾病已经成为我国最常见的疾病之一,是城乡居民主要死因,故早期发现、干预刻不容缓。高分辨力B型超声技术检测颈动脉内中膜厚度能够无创性地研究动脉粥样硬化的早期改变。大量研究证实,颈动脉粥样硬化与冠状动脉粥样硬化及高血压密切相关,且超声具有方便、安全、低廉的优越性。通过对颈动脉内中膜厚度的测定,可为冠心病和高血压的检测、评估提供重要的客观依据。     

Calcium distribution in the vessel wall and intima-media thickness of the human carotid arteries

Increased common carotid artery (CCA) intima-media thickness (IMT) measured by B-mode ultrasound is an early marker of the atherosclerotic process. Arterial calcification is not clearly understood. Using the particle-induced X-ray emission (PIXE) method, we have looked for the location in the artery wall where calcium accumulated in the early phase of atherosclerosis. Twelve segments of CCAs of deceased stroke patients were investigated. In-vivo, carotid duplex ultrasound was performed with bilateral CCA IMT measurement at plaque-free sections. During autopsy, segments of carotid arteries were collected and filled under pressure with a stained histologic embedding material. The frozen arteries were cut into 60-microm-thick slices. Calcium distribution maps from the segments of arteries were determined by PIXE method. IMT measured by ultrasound and calcium distribution maps measured by PIXE were compared. In our cross-sectional study, using the PIXE analysis and ultrasound images, we could demonstrate early calcium accumulation in the media layer. Our results have also shown a significant relationship between calcium content of distributional maps measured by PIXE analysis and corresponding IMT on B-mode ultrasound images of human CCAs.     

血清内脏脂肪素水平与2型糖尿病患者颈动脉内中膜厚度相关性的研究

目的探讨血清内脏脂肪素水平与2型糖尿病患者颈动脉内中膜厚度（IMT）之间的关系。方法应用酶联免疫法测定80例2型糖尿病患者,并根据患者的颈动脉超声结果分为两组：IMT正常组和IMT增厚或斑块组。比较两组及40例正常对照者的血清脂联素水平,分析血清内脏脂肪素水平与IMT之间的关系。结果（1）2型糖尿病组血清内脏脂肪素水平高于对照组（P〈0．01）。（2）IMT正常组与IMT增厚或斑块组相比较,腰臀比、TG、HDL．C、血清内脏脂肪素水平,差异均有统计学意义（P均〈0．05）。（3）Logistic回归分析显示,血清内脏脂肪素含量较高、年龄增长、TG增高、HDL-C降低是2型糖尿病患者IMT增厚的危险因素。结论高血清内脏脂肪素水平可能是2型糖尿病患者动脉粥样硬化的危险因素。     

2型糖尿病踝肱指数和颈动脉内中膜厚度关系

目的观察2型糖尿病患者踝肱指数(ABI)和颈动脉内中膜厚度(IMT)关系。方法对106例2型糖尿病患者采用MD2多普勒血流探测仪测定ABI,并依据ABI分为外周动脉疾病(PAD)组(ABI≤0.9)和非外周动脉疾病(NPAD)组(ABI>0.9),同时采用飞利浦M2540A彩色超声检查仪检测所有患者IMT,进行组间比较,并对二者进行线性相关分析。结果 ABI≤0.9者72例,占14.78%;与NPAD组比较,PAD组IMT异常率显著增高(P<0.01);相关分析显示,2型糖尿病患者ABI与IMT呈显著负相关。结论 ABI和IMT检查可作为筛查2型糖尿病患者周围血管病变与糖尿病合并颈动脉粥样硬化的方法,二者常并行出现,可联合作为筛查糖尿病大血管病变的方法。     

绝经后女性骨密度及骨保护素与颈动脉粥样斑块形成的关系

目的 探讨绝经后女性骨密度及骨保护素与颈动脉粥样斑块形成的关系.方法 测定218例绝经后女性血清骨保护素(OPG)及血脂的浓度,并进行颈动脉彩超检查及腰椎骨矿密度(BMD)检查.根据颈动脉彩超及腰椎骨密度情况,将研究对象分为正常组,单纯颈动脉斑块形成组(CAP组),单纯骨密度下降组(BMD组).结果 3组血清OPG水平...     

阿托伐他汀对心血管病患者颈动脉粥样斑块的作用研究

目的探讨阿托伐他汀对冠心病患者颈动脉粥样硬化的影响,并探讨其疗效及安全性。方法将102例冠心病合并颈动脉粥样硬化患者随机分为阿托伐他汀组(51例)及对照组(51例),分别于给药前和给药1、3、6、12个月后采用高频超声检测颈动脉,记录颈动脉内膜中层厚度(IMT)和粥样硬化斑块面积,并测定其血脂水平。结果治疗组51例患者经阿托伐他汀血清低密度脂蛋白-胆固醇(LDL-c)、TC、TG在治疗1个月后开始下降,高密度脂蛋白-胆固醇(HDL-C)上升,与对照组比较差异有统计学意义(P<0.01),但斑块未见缩小;治疗3个月后,粥样斑块的IMT由(2.23±0.32)mm下降(1.69±0.22)mm,下降幅度为31.94%,与对照组比较差异有统计学意义(P<0.01)。结论阿托伐他汀对冠心病患者的颈动脉粥样硬化斑块具有延缓和稳定作用,对血胆固醇增高的心脑血管病人,及周围大动脉斑块的病人都能获益,从而降低了中风和慢性闭塞性周围动脉硬化,降低了致残率。