颈动脉圆周应变在心血管危险分层中的临床应用价值  

The clinic value of two-dimensional carotid strain in cardiovascular risk stratification

作　　者：黄润青[1] 邓又斌[1] 王立平[1] 王丁[1] 李阳[1] 孙杰[1] 刘琨[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声科,武汉430030

出　　处：《中华超声影像学杂志》2012年第12期1022-1025,共4页Chinese Journal of Ultrasonography

摘　　要：目的应用超声二维斑点追踪检测无颈动脉粥样硬化斑块患者颈动脉整体圆周应变（cireumferentialstrain，CS），探讨其评价颈动脉弹性及其在心血管危险分层中的临床应用价值。方法选择95例心内科住院患者，根据Framingham危险评分（Framinghamriskscore，FRS）分为低危组、中危组、高危组。测量各组患者颈总动脉收缩期峰值CS和颈动脉内中膜厚度（intima-medialthickness，IMT），并对CS加以脉压差校正（CS／PP），比较各组的CS、CS／PP和IMT，并对CS、CS／PP和IMT进行相关分析。结果CS、cs／PP、IMT在低危组和中危组，低危组和高危组中差异有统计学意义（P〈0．05）；IMT、CS在中危组和高危组中差异无统计学意义（P=0．23，P=0．57）。cs／PP在低危组、中危组和高危组中差异有统计学意义（P〈0．05）。CS、CS／PP与IMT呈负相关（r分别为-0．30，-0．33，P〈0．05）。结论超声二维斑点追踪可以反映颈动脉的弹性变化，IMT和CS可以分别从结构和功能上评价颈动脉硬化，二者的结合能够更准确地评价动脉硬化的亚临床状态，预测冠状动脉病变的程度。Objective To assess the two-dimensional carotid strain as an index of arterial stiffness in patients without carotid atherosclerotic plaques, and its clinic value in cardiovascular risk stratification. Methods All patients were divided into three groups （low risk, intermediate risk, high risk group） by Framingham cardiovascular risk scores,two-dimensional carotid circumferential strain （CS）,carotid intima- media thickness （IMT） were evaluated. CS was adjusted for pulse pressure （CS/PP）. Results CS,CS/PP, IMT were significant difference between low risk and intermediate risk groups,low risk and high risk groups （ P 〈0.05）. IMT and CS were not significant difference between intermediate risk and high risk group （P = 0.23, P = 0.57）. CS/PP was significant difference between three groups （ P d0.05）. Both CS and CS/PP were correlated with IMT （ r = - 0.30, r = - 0.33, P 〈0.05）. Conclusions Two dimensional strain could assess the carotid arterial mechanics. IMT and CS could evaluate the structural and functional alternations of carotid stiffness. Combining these two indices allowed more accurate evaluation of the subclinical phase of the atherosclerotic disease.

关 键 词：超声心动描记术 颈动脉 动脉粥样硬化 二维斑点追踪显像 

分 类 号：R445.1[医药卫生—影像医学与核医学]