超声右锁骨下动脉起始部内膜中层厚度对中青年早期动脉硬化的评估价值研究  

Evaluation Value of Thickness of the Beginning of Right Subclavian Artery on Early Arteriosclerosis in Young and Middle-aged Patients

作　　者：黄林海 李丽丽 吴劲峰 侯春燕 HUANG Linhai;LI Lili;WU Jinfeng;HOU Chunyan(Affiliated Dongguan Hospital,Southern Medical University(Dongguan People’s Hospital),Dongguan 523059,China;不详)

机构地区：[1]南方医科大学附属东莞医院(广东省东莞市人民医院),广东东莞523059

出　　处：《中国医学创新》2022年第22期25-29,共5页Medical Innovation of China

基　　金：东莞市社会科技发展(一般)项目(202050715001567)。

摘　　要：目的:探讨超声右锁骨下动脉起始部内膜中层厚度(IMT)对中青年早期动脉硬化的评估价值。方法:2020年7月-2021年6月在南方医科大学附属东莞医院(东莞市人民医院)接受体检的中青年人群420例,根据是否合并早期动脉硬化将所有入组患者分为早期动脉硬化组(n=157)与非早期动脉硬化组(n=263),对比其超声右锁骨下动脉起始部IMT及其他临床资料的差异。采用单因素、多因素logistic回归模型分析中青年人群早期动脉硬化出现的危险因素,采用受试者工作特征(ROC)曲线分析超声右锁骨下动脉起始部IMT对中青年人群早期动脉硬化的评估价值。结果:早期动脉硬化组右锁骨下动脉起始部IMT高于非早期动脉硬化组(P<0.05)。两组性别、年龄、体重指数(BMI)、高血压、吸烟、饮酒及空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)比较,差异均无统计学意义(P>0.05);两组糖尿病、高脂血症、高密度脂蛋白胆固醇(HDL-C)、同型半胱氨酸(Hcy)比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析发现,合并糖尿病、合并高脂血症、Hcy水平、IMT均为中青年人群出现早期动脉硬化的独立危险因素,HDL-C水平为保护因素(P<0.05)。ROC曲线显示,超声右锁骨下动脉起始部IMT诊断中青年早期动脉硬化的临界值为1.280 mm,AUC为0.855[95%CI(0.813,0.897)],对应的敏感度、特异度分别为93.54%、74.52%。结论:超声右锁骨下动脉起始部IMT是中青年早期动脉硬化的独立危险因素,且可能是辅助诊断早期动脉硬化的有效指标之一。Objective:To evaluate the value of ultrasound intima-media thickness (IMT) at the beginning of right subclavian artery in young and middle-aged patients.Method:A total of 420 middle-aged and young people who underwent physical examination in Affiliated Dongguan Hospital,Southern Medical University (Dongguan People’s Hospital) from July 2020 to June 2021 were divided into early atherosclerosis group (n=157) and group (n=263) according to whether they were complicated with early arteriosclerosis.The differences of IMT and other clinical data at the beginning of right subclavian artery were compared.Univariate and multivariate logistic regression models were used to analyze the risk factors of early arteriosclerosis in middle-aged and young people.The receiver operating characteristic (ROC) curve was used to analyze the value of ultrasonic IMT at the beginning of right subclavian artery in evaluation of early arteriosclerosis in young and middle-aged people.Result:The IMT at the beginning of the right subclavian artery in the early arteriosclerosis group was greater than that in the and non-early arteriosclerosis group (P0.05).There were significant differences in diabetes,hyperlipidemia,high density lipoprotein cholesterol (HDL-C) and homocysteine (Hcy) between the two groups (P<0.05).Multivariate logistic regression analysis showed that diabetes mellitus,hyperlipidemia,Hcy level and IMT were independent risk factors for early atherosclerosis in young and middle-aged people,HDL-C level was protective factor (P<0.05).ROC curve showed that the critical value of ultrasound IMT at the beginning of right subclavian artery for the diagnosis of early atherosclerosis in young and middle-aged adults was 1.280 mm,AUC was 0.855[95%CI (0.813,0.897)],corresponding sensitivity and specificity were 93.54% and 74.52%,respectively.Conclusion:The IMT at the beginning of the right subclavian artery is an independent risk factor for early arteriosclerosis in young and middle-aged people,and may be one of the effective indexes to ass

关 键 词：早期动脉硬化 右锁骨下动脉起始部 内膜中层厚度 超声 中青年 

分 类 号：R543.5[医药卫生—心血管疾病]