多中心无心脑血管疾病危险因素成年受检者颈动脉内-中膜厚度的相关因素分析  

Changes of carotid intimamedia thickness in adult population without cardio and cerebrovascular diseases risk factors:an analysis of multicenter research results

作　　者：杨雨佳 华扬[1] 马兆毅 贾凌云[1] 脑卒中高危人群筛查脑颈动脉规范化评估数据库课题组 Yang Yujia;Hua Yang;Ma Zhaoyi;Jia Lingyun;Carotid Artery Ultrasound Project Group(CAUPG)(Department of Vascular Ultrasound,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;不详)

机构地区：[1]首都医科大学宣武医院血管超声科,北京100053 [2]国家卫生健康委能力建设和继续教育中心

出　　处：《中国脑血管病杂志》2023年第8期537-543,共7页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的分析无心脑血管危险因素的成年受检者颈动脉内-中膜厚度(IMT)百分位数值及其影响因素。方法连续性纳入2019年12月至2021年12月国内53家医院参加的“脑卒中高危人群筛查脑颈动脉超声规范化评估”数据库中2738名无心脑血管疾病危险因素的成年受检者颈总动脉(CCA)内径、颈动脉球部(CB)内径、颈内动脉(ICA)内径及CCA远段IMT测值。按性别与年龄对IMT进行分层描述[百分位数值以第5、10、25、50、75、90及95百分位数(P_(5)、P_(10)、P_(25)、P_(50)、P_(75)、P_(90)、P_(95))表示],并依据IMT的中位数值将所有研究对象分为IMT<0.6 mm组和IMT≥0.6 mm组,比较两组受检者的年龄、性别、体质量指数(BMI)、侧别及CCA、CB、ICA内径,采用多因素Logistic回归分析方法分析IMT增加的影响因素。结果(1)女性平均IMT为(0.56±0.02)mm,男性平均IMT为(0.59±0.03)mm。女性和男性IMT百分位数值均随年龄的增长而增加(均P<0.01);对19~69岁颈总动脉远段IMT增长值的横断面计算结果显示,男性与女性IMT每年分别增加0.003、0.005 mm。(2)IMT与CCA内径(r=0.130,P<0.01)、ICA内径(r=0.067,P<0.01)、CB内径(r=0.143,P<0.01)、年龄(r=0.302,P<0.01)、BMI(r=0.142,P<0.01)均呈正相关性,男性IMT大于女性IMT(t=8.784,P<0.01),左侧与右侧IMT测值差异无统计学意义[左侧比右侧:(0.57±0.02)mm比(0.57±0.02)mm,t=-0.301,P=0.763]。(3)Logistic回归分析结果表明,CB内径(OR=1.193,95%CI:1.109~1.283)、年龄(OR=1.049,95%CI:1.042~1.055)、女性(OR=0.688,95%CI:0.602~0.787)为IMT增加的独立影响因素。结论年龄、性别、CB内径均为无心脑血管疾病危险因素成年受检者正常范围内IMT增加的影响因素。Objective To analyze the carotid intima-media thickness(IMT)percentile and its influencing factors in adult population without cardio and cerebrovascular diseases risk factors.Methods All of the 2738 adults without risk factors for cardiovascular and cerebrovascular diseases were continuously included in the“standardized evaluation database for cerebral vascular ultrasound screening in the high-risk population of stroke”database of 53 hospitals in China from December 2019 to December 2021.The diameter of common carotid artery(CCA),carotid artery bulb(CB),and internal carotid artery(ICA)and the IMT of the CCA distal segment were detected.The IMT were stratified by gender and age using percentile values(presented as 5th,10th,25th,50th,75th,90th,and 95th[P_(5),P_(10),P_(25),P_(50),P_(75),P_(90),P_(95)]).All study subjects were categorized into IMT<0.6 mm group and IMT≥0.6 mm group based on the median value of IMT,and the age,gender,body mass index(BMI),side and CCA,CB,ICA diameter between the two groups were compared.The influencing factors of IMT increase were analyzed by multifactorial Logistic regression analysis.Results(1)The mean IMT was(0.56±0.02)mm for females and(0.59±0.03)mm for males.The percentile value of IMT increased with age in all percentiles for both females and males(all P<0.01).The IMT cross-sectional growth values were calculated from 19 to 69 years of age,showing an IMT growth of 0.003 mm per year in males and 0.005 mm per year in females.(2)The diameter of CCA(r=0.130,P<0.01),the diameter of ICA(r=0.067,P<0.01),the diameter of CB(r=0.143,P<0.01),age(r=0.302,P<0.01)and BMI(r=0.142,P<0.01)were positively correlated with the IMT.The IMT in males was higher than females(t=8.784,P<0.01),the IMT on left and right had no statistical difference([0.57±0.02]mm vs.[0.57±0.02]mm,t=-0.301,P=0.763).(3)The Logistic regression analysis showed that the diameter of CB(OR,1.193,95%CI 1.109-1.283),age(OR,1.049,95%CI 1.042-1.055)and gender(OR,0.688,95%CI 0.602-0.787)were independent factors of the IMT inc

关 键 词：颈动脉内-中膜厚度 超声 动脉粥样硬化 心脑血管疾病危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]