超声评价颈动脉粥样硬化的临床研究

目的 探讨二维超声、多普勒超声及超声-生理学指标对颈动脉粥样硬化的评价。方法选取经临床确诊的颈动脉粥样硬化患者49例和正常人35例，分为观察组与对照组，进行颈总动脉（CCA）血流动力学、内一中膜厚度（IMT）及血管超声-生理学指标对照分析，确定评价颈动脉粥样硬化的可行性指标。结果 ①观察组左右侧CCA主干和分叉部IMT较对照组显著增厚（P〈0．01）；②观察组收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV）、平均血流速度（MV）均降低，与对照组比较差异有统计学意义（P〈0．05）；③观察组的扩张系数（De）和顺应系数（Cc）较对照组均减低，扩张系数两组比较差异有统计学意义（P〈0．05）；④颈动脉主干IMT与PSV、EDV、MV、Dc之间成负相关，与相应脉压（PP）、收缩压（SBP）、CCA的收缩期内径（Ds）、舒张期内径（Dd）、动脉壁僵硬度（wall stiffness）之间成正相关。结论 高频超声检查IMT、血流动力学参数PSV、EDV、MV降低，收缩期峰值血流速度与舒张末期血流速度比值（PSWEDV）升高，PI和RI升高，超声一生理学指标Dc和Cc减低，僵硬度的增加可作为诊断颈动脉粥样硬化较可靠指标。

Two-diamensional and Doppler ultrasonography evaluating atherosclerosis of carotid artery

Objective To explore the feasibility of multi - index of ultrasound in diagnosing atheresclerosis（As） of carotid artery. Methods Forty- nine patients with As（ atheresclerosis） of carotid artery considered as observed group（OG） and 35 normal subjects as control group（ CG） were enrolled in the study. ＂The indexes of hemodynamics, intima - media thickness（IMT） and ultrasound - physiology were compared between OG and CG. Results ① IMTs of both CCAs＇ thinks and bifurcations in OG were significantly thicker than those in CG （P 〈 0.01）; ② Peak systolic velocity（PSV）, end diastolic velocity（EDV） and mean velocity（MV） were decreased significantly in OG than those in CG（ P 〈 0.05） ; ③Both distensibility coefficient（Dc） and compliance coefficient（Cc） were decreased in OG but only Dc was decreased significantly（ P 〈 0.05） ;④IMTs of both CCAs＇ thinks were of negative correlation with blood velocity and Dc but positive correlation with pulse pressure（PP）, systolic pressure（SBP）, systolic diameter（Ds）, diastolic diame- ter（Dd） and wall stiffness（β） respectively. Conclusion The high - frequency ultrasonography of IMT of CCA is a precise way to evaluate As of carotid artery and the alteration of hemodynamics（such as decreased PSV, EDV, MV and increased PSV/EDV, PI, RI） and ultrasound- physiology （such as decreased Dc, Dd and increased ~3） are helpful indexes as well.