原发性干燥综合征患者颈动脉内膜厚度及其影响因素的初步研究  

Preliminary study on carotid intima thickness and its influencing factors in patients with primary Sjögren′s syndrome

作　　者：邢雨 吴铭 楚天舒[3] 张喜君 李寒笑[2] 曾甜 朱好辉 Xing Yu;Wu Ming;Chu Tianshu;Zhang Xijun;Li Hanxiao;Zeng Tian;Zhu Haohui(Department of Ultrasound,Zhengzhou University People′s Hospital,Zhengzhou 450003,China;Department of Ultrasound,Henan Provincial People′s Hospital,Zhengzhou 450003,China;Department of Rheumatology and Immunology,Henan Provincial People′s Hospital,Zhengzhou 450003)

机构地区：[1]郑州大学人民医院超声科,郑州450003 [2]河南省人民医院超声科,郑州450003 [3]河南省人民医院风湿免疫科,郑州450003

出　　处：《中华超声影像学杂志》2024年第4期294-299,共6页Chinese Journal of Ultrasonography

基　　金：国家重点研发计划(2022YFC3602400);河南省科技攻关项目(222102310053);2021年度河南省卫生健康中青年学科带头人培育项目(CYQ20220020);河南省医学适宜技术推广项目(SYJS2022019);2023年度河南省医学科技攻关计划联合共建项目(LHGJ20230017)。

摘　　要：目的应用24 MHz超高频超声探头测量原发性干燥综合征(pSS)患者的颈动脉内膜厚度(CIT),并探讨其影响因素。方法前瞻性连续入组2023年2-8月就诊于河南省人民医院的pSS女性患者31例作为pSS组,另选取同期年龄、体质指数相匹配的女性健康志愿者33例作为对照组。使用24 MHz超高频超声探头测量研究对象CIT、中膜厚度(CMT)和内中膜厚度(CIMT)。比较两组间一般临床资料、实验室指标及CIMT、CIT、CMT的差异,通过多因素回归分析探讨pSS患者CIT的影响因素。结果①两组间年龄、体质指数、收缩压、舒张压、血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1、白细胞计数、中性粒细胞计数、单核细胞计数、CMT比较,差异无统计学意义(均P>0.05);与对照组相比,pSS组的淋巴细胞计数减少,中性粒细胞/淋巴细胞比值、红细胞沉降率(ESR)、CRP升高,CIMT和CIT增厚,差异有统计学意义(均P<0.05)。②多因素线性回归分析显示,pSS患者中ESR是CIT的影响因素(β=0.401,P=0.009)。结论pSS患者CIT和CIMT均较正常人增厚,且ESR是CIT的主要影响因素,提示临床进行干预时应更加关注pSS患者ESR的检测。Objective To measure carotid intima thickness(CIT)in patients with primary Sjögren′s syndrome(pSS)by 24 MHz ultra-high frequency ultrasound probe,and explore its influencing factors.Methods Thirty-one female patients with pSS were prospectively and consecutively enrolled from the Henan Provincial People′s Hospital during February to August 2023 as pSS group.Additionally,33 healthy female volunteers,matched for age and body mass index(BMI),were selected as the control group.Carotid intima thickness(CIT),carotid media thickness(CMT),and carotid intima-media thickness(CIMT)were measured using a 24 MHz ultra-high frequency ultrasound probe.The difference of general clinical data,laboratory indicators and CIMT,CIT,CMT between the two groups were compared,and the influencing factors of CIT in pSS patients were explored by multivariate regression analysis.Results①There were no statistically significant differences between the two groups in terms of age,BMI,systolic blood pressure,diastolic blood pressure,blood glucose,total cholesterol,triglycerides,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A1,white blood cell count,neutrophil count,and monocyte count,as well as CMT(all P>0.05).However,compared to the control group,the pSS group showed a statistically significant decrease in lymphocyte count,and an increase in the neutrophil/lymphocyte ratio,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),CIMT and CIT(all P<0.05).②Multivariate linear regression analysis indicated that in pSS patients,ESR remained a significant influencing factor for CIT(β=0.401,P=0.009).Conclusions In patients with pSS,both CIT and CIMT are found to be thicker compared to healthy individuals.Moreover,the ESR is identified as a primary influencing factor for CIT.This suggests that clinical interventions for pSS patients should pay more attention to ESR.

关 键 词：超高频超声 干燥综合征 原发性 颈动脉内膜厚度 免疫炎症指标 

分 类 号：R593.2[医药卫生—内科学]