无心脑血管疾病危险因素成年受检者颈动脉管腔结构变化的相关因素分析  

Analysis of related factors of changes in carotid artery structure in adults without cardio and cerebrovascular disease risk factors

作　　者：全雪萌 华扬[1] 贾凌云[1] 马兆毅 脑卒中高危人群筛查脑颈动脉规范化评估数据库课题组 Quan Xuemeng;Hua Yang;Jia Lingyun;Ma Zhaoyi;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 [3]不详

出　　处：《中国脑血管病杂志》2024年第2期93-101,共9页Chinese Journal of Cerebrovascular Diseases

基　　金：国家卫生健康委能力建设和继续教育中心多中心课题资助项目。

摘　　要：目的分析无心脑血管疾病危险因素成年受检者颈动脉管腔结构变化及其影响因素。方法回顾性连续纳入2019年12月至2021年12月多中心“脑卒中高危人群筛查脑颈动脉超声规范化评分”数据库2738例无心脑血管疾病相关危险因素的成年受检者(男787例,女1951例),分别将男性、女性分为18~29、30~39、40~49、50~59、≥60岁5组,统计比较各年龄组间颈动脉内-中膜厚度(IMT)、颈总动脉内径(D_(CCA))、颈动脉球部内径(D BULB)、颈内动脉内径(D_(ICA))及颈动脉不同节段内径之比[以颈动脉指数(CI)表示,CI_(BULB)/CCA为D_(BULB/DCCA),CI_(BULB)/ICA为D BULB/D_(ICA),CI_(ICA/CCA)为D_(ICA)/D_(CCA)]的差异性,并采用Spearman相关性分析及单因素线性回归方法分析各参数随年龄的变化情况。采用单因素分析比较男女间以及不同侧别间各CI的差异,采用Spearman相关性分析方法分析各CI与颈总动脉IMT的相关性。应用多因素线性回归方法分析CI_(BULB)/CCA、CI_(BULB)/ICA及CI_(ICA/CCA)变化的影响因素。结果(1)IMT、D_(CCA)、D BULB、D_(ICA)、CI_(BULB)/CCA及CI_(BULB)/ICA与年龄呈显著正相关性(男性r值分别为0.121、0.229、0.260、0.055、0.107、0.229,女性r值分别为0.364、0.185、0.199、0.073、0.077、0.129,均P<0.01),CI_(ICA/CCA)与年龄呈负相关性(男性r=-0.118,女性r=-0.049,均P<0.05),且年龄每增长1岁,男性IMT、D_(CCA)、D BULB、D_(ICA)分别增长0.003、0.015、0.025、0.004 mm,女性IMT、D_(CCA)、D BULB、D_(ICA)分别增长0.005、0.011、0.018、0.005 mm。(2)男性CI_(BULB)/ICA小于女性(1.47±0.21比1.51±0.22;t=-5.566,P<0.01),CI_(ICA/CCA)大于女性(0.78±0.11比0.76±0.11;t=6.629,P<0.01);左侧CI_(BULB)/CCA(1.14±0.15比1.13±0.15;t=-2.973,P<0.05)、CI_(ICA/CCA)(0.77±0.11比0.76±0.11;t=-3.946,P<0.01)大于右侧。男女性别之间CI_(BULB)/CCA及左右侧之间CI_(BULB)/ICA差异均无统计学意义(男性比女性:1.13±0.15比1.13±0.15,t=1.212,P=0.226;左侧比右侧:1.49±0.22Objective To analyze the changes of carotid artery structures and their influencing factors among the adults without cardio and cerebrovascular disease risk factors.Methods All 2738 adult subjects(787 males and 1951 females)without cardio and cerebrovascular disease risk factors were continuously included in the national multi-center Standardized Brain-Carotid Ultrasound Evaluation Database from December 2019 to December 2021.Males and females were divided into 5 groups of 18-29 years old,30-39 years old,40-49 years old,50-59 years old,and≥60 years old respectively,and the intima-media thickness(IMT),the diameter of common carotid artery(D_(CCA)),carotid artery bulb(D BULB),internal carotid artery(D_(ICA)),and the ratio of diameters of different segments carotid artery index(CI;CI_(BULB)/CCA[D_(BULB/DCCA)],CI_(BULB)/ICA[D BULB/D_(ICA)]and CI_(ICA/CCA)[D_(ICA)/D_(CCA)])were counted and compared for each group.The Spearman correlation coefficient and univariate linear regression analysis were used to analyze the changes of each parameter with age.The univariate linear regression analysis was used to compare the difference of CI between female and male,and left side and right side.The Spearman correlation coefficient was used to analyze the correlation between CI and carotid artery IMT.The multiple regression analysis was used to analyze the influencing factors of CI_(BULB)/CCA,CI_(BULB)/ICA and CI_(ICA/CCA).Results(1)IMT,D_(CCA),D BULB,D_(ICA),CI_(BULB)/CCA and CI_(BULB)/ICA were significantly positively correlated with age(r-values for males were 0.121,0.229,0.260,0.055,0.107,0.229,respectively,for females were 0.364,0.185,0.199,0.073,0.077,0.129,respectively,all P<0.01),and CI_(ICA/CCA) was negatively correlated with age(males:r=-0.118,females:r=-0.049,all P<0.05).For every 1 year increase of age,the IMT,D_(CCA),D BULB and D_(ICA) in males increased by 0.003 mm,0.015 mm,0.025 mm,0.004 mm respectively,and 0.005 mm,0.011 mm,0.018 mm,0.005 mm in females respectively.(2)The CI_(BULB)/ICA in males were lower than fe

关 键 词：超声检查 颈动脉 结构 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]