颈动脉粥样硬化伴OSAHS患者的颈动脉超声研究  

Study of carotid atherosclerosis combined with OSAHS patients by carotid artery ultrasound

作　　者：秦璐[1] 赵颖[1] 佟隽瑶 郝泽良[1] QIN Lu, ZHAO Ying, TONG Jun-yao, HAO Ze-liang(Department of Stomatology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院口腔科,北京100053

出　　处：《中国医刊》2018年第7期756-760,共5页Chinese Journal of Medicine

基　　金：中华口腔医学会口腔疾病与全身疾病关系专项基金(CSA-Z2015-06)

摘　　要：目的通过颈动脉血管超声研究颈动脉粥样硬化伴不同严重程度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者的颈动脉特点,探讨OSAHS在颈动脉粥样硬化病变中的可能作用。方法选择2016年1月至2017年8月首都医科大学宣武医院收治的颈动脉粥样硬化病变伴OSAHS患者150例,根据严重程度分为轻度OSAHS组(54例)、中度OSAHS组(40例)、重度OSAHS组(56例),收集3组患者近半年内的颈动脉血管超声结果进行分析。结果不同严重程度的OSAHS患者之间双侧颈动脉最大斑块的厚度及双侧颈动脉内膜中层厚度(carotid intima-medial thickness,CIMT)均值差异有显著性(P<0.05);轻度OSAHS组患者颈动脉最大斑块厚度明显小于重度OSAHS组,差异有显著性(P<0.05),双侧CIMT均值明显小于中度及重度OSAHS组,差异均有显著性(P<0.05,P<0.01)。Pearson相关分析显示,呼吸暂停低通气指数与颈动脉双侧最大斑块厚度间呈明显正相关(r=0.19,P=0.02)。不同严重程度OSAHS患者间双侧颈总动脉和颈内动脉的血流速度指标差异均无显著性(P>0.05)。结论随OSAHS严重程度加重,颈动脉最大斑块厚度和双侧CIMT均值逐渐增大;OSAHS的严重程度可能影响颈动脉粥样硬化的发展。Objective To study characteristics of the carotids in patients with carotid atherosclerosis and obstructive sleep apnea hypopnea syndrome（OSAHS）by carotid artery ultrasound in order to explore probable influence of OSAHS on carotid atherosclerosis. Method Suspectable OSAHS patients were screened among patients with carotid atherosclerosis. After PSG tests, OSAHS patients were confirmed and divided into 3 groups by severity： 54 mild cases, 40 moderate cases and 56 severe cases. Collect and analyze the carotid artery ultrasound results ofthe last 6 months. Result Significant difference was found in carotid plaque thickness of the biggest plaque and bilateral CCA CIMTmeanamong 3 groups of patients. They increase as OSAHS is more severe. Moreover, there was significant difference incarotid plaque thickness between mild and severe OSAHS patients（P〈0.05）. Furthermore, significant difference was found in bilateral CCA CIMTmeanbetween mild and moderate OSAHS patients（P〈0.01）, also between mild and severe OSAHS patients（P〈0.01）. Besides, AHI and carotid plaque thickness showed a positive correlation between each other. However, PSV and EDV of CCA, ICA and carotid bulb had no significant difference among OSAHS patients with varied severity, nor did bilateral mean and max blood flow velocities. Conclusion More severe OSAHS is, more CIMT and carotid plaque thickness are, which indicates that OSAHS has a probable effect on carotid atherosclerosis development.

关 键 词：颈动脉粥样硬化 阻塞性睡眠呼吸暂停低通气综合征 颈动脉内膜中层厚度 颈动脉斑块 

分 类 号：R783.9[医药卫生—口腔医学] R767.19[医药卫生—临床医学]