血管弹性参数评价主动与被动吸烟者颈动脉硬化早期改变

目的：探讨血管弹性参数在评价主动与被动吸烟者颈动脉硬化早期改变中的价值。方法运用血管回声跟踪（Echo-tracking，ET）技术检测主动吸烟者36例、被动吸烟者34例及正常对照组40例的颈动脉血管弹性参数：僵硬度（β）、压力-应变弹性系数（Eρ）、动脉顺应性（AC）、脉搏波放大指数（AI）及脉搏波传导速度（PWVβ），并与常规二维超声测量的内-中膜厚度（IMT）及颈动脉最大内径（Ds）和颈动脉最小内径（Dd）比较。结果主动吸烟组和被动吸烟组的IMT稍增厚、Ds 与Dd稍增大，但与对照组相比差异均无明显统计学意义（P＞0.05）。主动与被动吸烟组的β、Eρ、AI、PWVβ均高于对照组，差异均有显著统计学意义（P＜0.01）；主动与被动吸烟组的AC均低于对照组，差异均有显著统计学意义（P＜0.01）。主动吸烟组AI、PWVβ高于被动吸烟组，差异均有统计学意义（P＜0.05）；AC、β和Eρ在主动与被动吸烟组之间无明显统计学差异（P＞0.05）。结论血管弹性参数能在内-中膜厚度及血管管腔内径尚未出现明显改变时评估吸烟对颈动脉动脉硬化早期的影响。主动吸烟和被动吸烟均能引起颈动脉弹性的改变，主动吸烟者的改变更为显著，但被动吸烟者的早期动脉硬化改变不容忽视。

Elasticity Parameter Evaluate the Early Changes of Carotid Arteriosclerosis in Active Smokers and Passive Smokers

Objective To discuss the value of elasticity parameter in evaluation of the early changes of carotid arteriosclerosis in active smokers and passive smokers.Methods 36 active smokers, 34 passive smokers and 40 normal persons （the control group） were enrolled in this study.Echo-tracking （ET） technology were used to evaluate the carotid artery elasticity parameter： stiffness parameter （β）,pressure-strain elastic modulus（Eρ）,arterial compliance（AC）,pulse amplification index（AI）,and Pulse wave transmission speed （PWVβ）. The routine ultrasound parameter intima-media thickness （IMT） was compared with the elasticity parameter.Results The parameter β、Eρ、AI、PWVβ were significant higher in the active and passive smoke group than that in the control group （P〈0.01）, while AC was significant lower in active and passive smokers than that in the control group （P〈0.01）.AI and PWVβ were higher in active smokers than that in passive smokers, and the difference were significant （P〈0.05）, but there were no significant statistic difference in AC、β and Eρ between active smokers and passive smokers（P〉0.05）. IMT was slightly incrassate in active and passive smoker groups, but there were no significant statistic difference when compared with the control group（p〉0.05）.Conclusion elasticity parameter can evaluate the early changes of carotid arteriosclerosis before the obvious changes appear in the IMT. Both active and passive smoking can cause the changes of elasticity in carotid artery, and this kind of changes may more obvious in the active smokers. However, we must not lost sight of the early arteriosclerosis in the passive smokers.