极速脉搏波实时定量技术在中老年高脂血症患者颈动脉粥样硬化评估中的应用  

Application of Ultrafast Ultrasound Imaging Pulse Wave Velocity Assessing Carotid Atherosclerosis in Middle-aged and Elderly People with Hyperlipidemia

作　　者：孟令萃 叶思婷 周婷 乔妙 张建兴 MENG Lingcui;YE Siting;ZHOU Ting;QIAO Miao;ZHANG Jianxing(Ultrasound Department,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二附属医院超声科,广东广州510120

出　　处：《中国医药指南》2022年第10期1-4,共4页Guide of China Medicine

基　　金：广东省中医药局面上项目(项目编号:20201137)。

摘　　要：目的应用极速脉搏波实时定量技术(ultra-fast ultrasound imagine pulse wave velocity,ufPWV),探讨中老年高脂血症患者颈动脉血管弹性与动脉粥样硬化(AS)相关性的应用价值。方法选取在我院体检中心接受健康体检的中老年患者95例,其中高脂血症患者45例,血脂正常的对照组50例,常规测量颈动脉内-中膜厚度(IMT),采用ufPWV技术检测两组患者颈动脉脉搏波指标收缩早期速度(PWV-BS)及收缩末期速度(PWV-ES),比较高血脂患者中IMT正常组与增厚组的相关参数,多元线性回归分析年龄、IMT、TC、TG、LDL、HDL与PWV-BS、PWV-ES的相关影响因素。结果高血脂组年龄、IMT、TC、TG、LDL、HDL高于正常对照组(P<0.05);高脂血症组颈动脉PWV-BS、PWV-ES均高于对照组(P<0.05);高脂血症组患者中,IMT增厚组颈动脉PWV-BS及PWV-ES均高于IMT正常组(P<0.05);多元线性回归分析结果显示PWV-BS的影响因素为IMT、TC、LDL,而PWV-ES的影响因素为年龄与LDL,因此PWV-BS与PWV-ES的共同独立影响因素均为LDL。而高血脂组患者中,PWV-BS的影响因素为TC、HDL,PWV-ES的影响因素为TG、TC、LDL、HDL,高血脂组PWV-BS与PWV-ES的共同影响因素均为TC与HDL。结论随着血脂水平的升高及颈动脉内-中膜厚度的增加,PWV-BS、PWV-ES值随之升高,ufPWV可有效评估中老年高脂血症患者的早期颈动脉硬化。对于中老年高血脂人群,在IMT正常或增厚未形成斑块时,PWV-BS、PWV-ES值可定量评估其血管弹性,从而对相关人群进行AS危险风险分层管理,为该类人群早期临床干预提供了一种新的诊断方法。Objective To evaluate the artery elasticity parameters in middle-aged and elderly people with hyperlipidemia measured by ultra-fast ultrasound imagine pulse wave velocity(ufPWV),and conduct a dynamic evaluation of the change in vascular elasticity and progression level of early-stage atherosclerosis.Methods A total of 95 middle-aged and elderly patients were investigated,including 45 patients with hyperlipidemia and 50 healthy persons,and were selected for routine measurement of carotid intima-media thickness(IMT).ufPWV at two time points were detected with early systolic velocity(PWV-BS)and late systolic velocity(PWV-ES),and the related parameters of normal IMT group and thickened IMT group in hyperlipidemia patients were compared,and multiple linear regression analysis was conducted to analyze the related influencing factors of age,IMT,TC,TG,LDL,HDL,PWV-BS,PWV-ES.Results Age,IMT,TC,TG,LDL and HDL in hyperlipidemia group were higher than those in normal control group(P<0.05).The PWV-BS and PWV-ES of carotid artery in hyperlipidemia group were higher than those in control group(P<0.05).In hyperlipidemia group,carotid artery PWV-BS and PWV-ES in IMT thickening group were higher than those in normal IMT group(P<0.05).The influencing factors of PWV-BS were IMT,TC and LDL,while the influencing factors of PWV-ES were age and LDL,so the common independent influencing factors of PWV-BS and PWV-ES were LDL.In the hyperlipidemia group,TC and HDL were the influencing factors of PWV-BS,TG,TC,LDL and HDL were the influencing factors of PWV-ES,TC and HDL were the common influencing factors of PWVBS and PWV-ES in the hyperlipidemia group.Conclusion With the increase of blood lipid level and carotid intima-media thickness,the values of PWV-BS and PWV-ES increased.ufPWV can effectively evaluate the early stage of carotid atherosclerosis in middle-aged and elderly patients with hyperlipidemia.

关 键 词：极速脉搏波超声成像 PWV-BS PWV-ES 高脂血症 

分 类 号：R589.2[医药卫生—内分泌]