颈动脉内膜中层厚度测量和超声回声跟踪技术检测高脂蛋白(a)血症家族成员颈动脉粥样硬化程度研究  

Dectection of the Degree of Carotid Artery Atherosclerosis in High Lp( a) Family Members by Carotid Intima-media Thickness Measurement and Ultrasonic Echo Tracking Technique

作　　者：张辉[1] 余舒杰[2] 毛永江[1] 张二红 郑荣琴[1] 

机构地区：[1]中山大学附属第三医院超声科,广东省广州市510630 [2]中山大学附属第三医院心血管内科,广东省广州市510630 [3]不育与性医学科

出　　处：《中国全科医学》2015年第30期3759-3762,3768,共5页Chinese General Practice

摘　　要：目的探讨应用颈动脉内膜中层厚度（IMT）测量和超声回声跟踪（ET）技术检测高脂蛋白（a）〔Lp（a）〕血症家族颈动脉粥样硬化程度的价值。方法选择2012年1月—2014年12月在中山大学附属第三医院就诊的2个高Lp（a）血症家族61人为病例组。按照年龄将其分为3个亚组,10~20岁亚组16人,21~40岁亚组26人,41~58岁亚组19人。同时选择在本院体检的与病例组各亚组年龄、性别匹配的健康志愿者61人为对照组。测量左侧颈总动脉（LCCA）IMT及右侧颈总动脉（RCCA）IMT,并利用超声ET技术检测双侧颈总动脉硬化程度〔硬化度（β）、弹性系数（Ep）、顺应性（AC）、膨大系数（AI）、脉搏波传导速度（PWVβ）〕。结果病例组10~20岁亚组与对照组10~20岁亚组LCCA、RCCA的IMT、β、Ep、AC、AI、PWVβ比较,差异无统计学意义（P〉0.05）。病例组21~40岁亚组与对照组21~40岁亚组LCCA、RCCA的IMT、AI比较,差异无统计学意义（P〉0.05）;病例组21~40岁亚组与对照组21~40岁亚组LCCA、RCCA的β、Ep、AC、PWVβ比较,差异有统计学意义（P〈0.05）。病例组41~58岁亚组与对照组41~58岁亚组LCCA、RCCA的IMT比较,差异有统计学意义（P〈0.05）;病例组41~58岁亚组与对照组41~58岁亚组LCCA、RCCA的β、Ep、AC、AI、PWVβ比较,差异无统计学意义（P〉0.05）。结论IMT测量可能不适合作为一个敏感指标用于发现高Lp（a）血症患者早期颈动脉粥样硬化。高Lp（a）血症家族中20岁以下的成员,超声ET技术难以发现颈动脉粥样硬化程度;21~40岁的成员,超声ET技术可以作为一种敏感的手段用以发现早期颈动脉粥样硬化程度;41~58岁的成员,由于血管内已经出现斑块等中晚期病变,超声ET技术不再适合评价其颈动脉粥样硬化程度。Objective To investigate the value of carotid intima- media thickness（ IMT） measurement and ultrasonic echo tracking（ ET） technique in the detection of the degree of carotid artery atherosclerosis in high Lp（ a） family members. Methods 61 patients in two high Lp（ a） families who were treated in the Third Affiliated Hospital of Sun Yat- sen University from January 2012 to December 2014 as case group were enrolled in the study. According to age,the patients were divided into three subgroups： 10- 20 subgroup（ n = 16）,21- 40 subgroup（ n = 26）,41- 58 subgroup（ n = 19）.Meanwhile,61 healthy volunteers who have matching ages and genders with the subgroups of case group were also enrolled. The carotid IMT of left common carotid artery（ LCCA） and right common carotid artery（ RCCA） was measured,and the indexes of the stiffness degree of bilateral common carotid artery were also measured,including the arterial stiffness index（ β）,pressure-strain elastic modulus（ Ep）, arterial compliance（ AC）, augmentation index（ AI）, and pulse wave velocity（ PWVβ）.Results 10- 20 subgroup of case group and 10- 20 subgroup of control group were not significantly different（ P〈0. 05） in IMT,β,Ep,AC,AI and PWVβ of LCCA and RCCA. 21- 40 subgroup of case group and 21- 40 subgroup of control group were not significantly different（ P〈0. 05） in IMT and AI of LCCA and RCCA; 21- 40 subgroup of case group and 21- 40 subgroup of control group were significantly different（ P〈0. 05） in β, Ep, AC and PWVβ of LCCA and RCCA. 41- 58 subgroup of case group and 41- 58 subgroup of control group were significantly different（ P〈0. 05） in IMT of LCCA and RCCA; 41- 58 subgroup of case group and 41- 58 subgroup of control group were not significantly different（ P〈0. 05） in β,Ep,AC,AI and PWVβ of LCCA and RCCA. Conclusion IMT measurement may not be a sensitive method to detect early carotid artery atherosclerosis in patients with high Lp（ a）. Ultrasonic ET technique can h

关 键 词：颈动脉疾病 动脉粥样硬化 高脂蛋白血症 颈动脉内膜中膜厚度 超声检查 

分 类 号：R589.2[医药卫生—内分泌]