血管回声追踪技术评价吸烟及相关因素对国人男性颈动脉弹性的影响  

Influence of smoking and the related risk factors on carotid elasticity in Chinese males by echo tracking

作　　者：苏楠[1] 黄品同[1] 张超[1] 罗洪霞[1] 洪玉蓉[2] 刘学明[2] 肖丹[3] 郭瑞军[3] 马琳[4] 李治安[5] 

机构地区：[1]温州医学院附属第二医院超声科,325027 [2]浙江大学医学院附属第二医院超声科 [3]首都医科大学附属北京朝阳医院 [4]河北联合大学附属医院 [5]首都医科大学附属北京安贞医院

出　　处：《中华超声影像学杂志》2013年第4期308-312,共5页Chinese Journal of Ultrasonography

摘　　要：目的应用血管回声追踪（E—Tracking，ET）技术评价吸烟及相关因素对国人男性颈动脉弹性的影响。方法2009年8至2011年8月对4819例男性国人纳入研究对象，年龄10～85岁，平均年龄（37．13±11．30）岁，其中吸烟不伴危险因素1319例，吸烟伴高血压、高血脂、糖尿病任意一种或一种以上危险因素1890例，正常人群1610例。应用ET技术对颈总动脉血流动力学进行量化分析以评估动脉硬化参数，包括压力应变弹性参数系数（Ep）、僵硬度（B）、顺应性（AC）、脉搏波传导速度（PWVβ）、膨大指数（AI）。并建立多元线性回归模型来分析年龄、吸烟指数、糖尿病、高血脂、右臂收缩压及右臂舒张压等6个因素对各个弹性参数的预测效果。结果①入选对象的颈动脉弹性参数值左右对比，β、Ep、PwV8、AC及AI均具有统计学差异，且右侧弹性参数值均较左侧数值大（P〈0．05）。②Pearson相关分析表明：年龄、吸烟指数及右臂收缩压与β、Ep及PwVp呈中度正相关，与AC呈中度负相关，与AI呈低度正相关；糖尿病、高血脂及右臂舒张压与β、Ep、PwVp及AI呈低度正相关，与Ac呈低度负相关。③多元线性回归分析结果：年龄对颈动脉β、Ep、PwVp、AC及AI的影响最大；右臂收缩压对颈动脉弹性功能的影响次之；高血脂对颈动脉弹性功能的影响位于第3位；吸烟指数对颈动脉弹性的影响位于第4位；糖尿病对动脉弹性（β、Ep及AI）及右臂舒张压对动脉弹性（PWVβ）的影响较小（P〉0．05）。结论ET能早期发现颈动脉内皮功能的改变；年龄、血压、高血脂、吸烟指数及高血糖与动脉弹性功能有关，并对动脉弹性的影响依次下降。Objective To investigate the carotid artery elasticity in Chinese males with smoking and the related influencing factors with echo tracking（ET） technique. Methods 4819 persons were included in the study[age range, 10-85 years-mean age （37.13± 10.30） years], 1319 smokers with no risk factors （hypertension, hyperglycemia and hyperlipidemia）, 1890 smokers with one or more than one factors. Quantitative analysis was made on hemodynamics of carotid artery by ET to evaluate the blood vessel elastic modulus, such as pressure-strain elastic modulus （ Ep）, stiffness parameters （ β）, arterial compliance （ AC）, pulse wave velocity（PWV~） and augmentation index（AI）. A multiple linear regression model on the basis of the risk factors was obtained, including aging, cigarette-smoke index（CSI）, hyperglycemia, hyperlipidemia, systolic pressure and diastolic pressure of the right upper extremity. Results （1）β, Ep, AC, AI and PWVβ of the right carotid artery were higher than those of the left in every group （ P〈0.05）. （2）The following results ware obtained by the Pearson correlation analysis., there was moderate positive correlation between aging, CSI, systolic pressure and β, Ep, PWVβ, and moderate negative correlation between aging, CSI, systolic pressure and AC,but low positive correlation between aging, CSI, systolic pressure and AI. There was low correlation between hyperglycemia, hyperlipidemia and β, Ep, PWVβ, Al, AC. （3） The results revealed by multiple linear regression analysis were that the effects of aging on β,Ep, PWVβ, Al and AC was greatest,and systolic pressure the second, hyperlipidemia the third, CSI the forth. And there was less effects of hyperglycemia on β, Ep and AI, so was diastolic pressure on PWVβ. Conclusions Aging, hypertension, hyperlipidemia,CSI,hyperglycemia are important risk factors of the carotid artery elasticity,and the degree decreased systematically. ET can be used to assess the vessel endothelial dysfunction,which is a convenient,

关 键 词：超声检查 颈动脉 弹性 吸烟 血管回声跟踪显像 

分 类 号：R445.1[医药卫生—影像医学与核医学]