1202例中老年人颈动脉硬度及相关因素研究

目的 研究自然人群中老年人颈动脉硬度及相关因素,为预防亚临床动脉硬化提供依据。方法 参照ARIC方案于2002年10月对北京石景山区43～73岁城乡居民1202人进行高分辨率B型超声颈动脉检查,测量双侧颈动脉近端、远端和窦部的内径和硬度(包括紧张度、扩张度和僵硬度),比较性别、年龄和部位之间的差异并行相关因素分析。结果 (1)硬度指标在各年龄段之间(小于55岁、55-64岁和大于65岁)差异有显著性(P<0.01);(2)男女性别间比较,在>65岁年龄段(老年人群)近端双侧和远端左侧动脉扩张性和僵硬度在男女之间存在明显差异(P<0.05);在窦部,仅在<55岁年龄段(中年人群)右侧动脉扩张性、僵硬度和左侧动脉紧张度在男女之间有明显差异(P<0.05);(3)不同测量部位间比较:窦部的动脉扩张性和动脉紧张度明显小于近端和远端(P<0.01);僵硬度则明显大于近端和远端(P<0.01);(4)相关分析发现:双侧颈总动脉远端僵硬度与血压、内中膜厚度、年龄、体重指数、血糖、女性总胆固醇、甘油三酯呈明显正相关(P<0.05)。结论 中老年人颈动脉硬度指标存在部位和性别差异,并与年龄、血压水平、内中膜厚度、血糖、体重指数及血脂明显相关。防治的重点应是降低血压、血糖,控制体重和调脂治疗。

Carotid stiffness and its correlation factors in 1202 middle-aged and old people

Objective To prevent subclinical atherosclerosis we studied carotid stiffness and its correlation factors in middle-aged and old people. Methods According to the Atherosclerosis Risk in Communities ( ARIC) study, we measured the common carotid diameter and carotid stiffness, including arterial strain ( AS ) , arterial distensibility ( AD) and arterial stiffness ( ASt ) with high-resolution ultrasonography in 1202 middle-aged and old people, with age of 43 - 73 yesrs, residing in Shijingshan district in Beijing,during Autumn in 2002. The difference and correlative factors were analysed on sex, age and the different position of carotid. Results ( 1) There are significant differences in carotid stiffness among the different age groups ( < 55 years age group ,55-64 years age group and >5 years age group) ( P < 0. 01). (2) There are significant differences in AD and ASt on the proximal section of both carotid and the distal section of left carotid between men and women in the age group of > 65 years. The differences in AD and ASt at right carotid bulb and AS at left carotid bulb were found between men and women in the age group of <55 years(P <0. 05). (3) AD and AS at the bulb were smaller than that at the proximal and distal port of carotid. (P < 0. 01). ASt at the bulb was larger than that at the near and far wall of carotid ( P < 0. 01). (4) ASt of both common carotid was significantly correlated with blood pressure, the common carotid artery intima-media thickness (IMT) , age, weight index, blood sugar, serum cholesterol and triglyceride levels (P < 0. 05). Conclusion There are differences in carotid stiffness between male and female and among different sections of carotid artery in middle age and old people. Carotid stiffness are correlated with age, blood pressure, IMT, blood sugar, body mass index and blood lipids. The prevention of subclinical atherosclerosis should pay attention to maintain normal blood pressure and blood sugar, to control weight, to adjust blood cholesterol and phospholipid and to control increasing IMT.