超高频超声联合全息血管硬度分析技术评估强直性脊柱炎患者颈动脉弹性和内膜厚度变化及其影响因素  

Preliminary study of carotid artery elasticity and intima thickness changes as assessed by ultrahigh-frequency ultrasound in combination with RF-data based quantitative analysis on vessel stiffness and the influencing factors in patients with ankylosing spondylitis

作　　者：吴承凯 袁建军[2] 楚天舒[3] 张喜君[2] 高帆[2] 吴铭 郭艳艳 朱好辉[2] Wu Chengkai;Yuan Jianjun;Chu Tianshu;Zhang Xijun;Gao Fan;Wu Ming;Guo Yanyan;ZhuHaohui(Xinriang Medical University Henan Provincial 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,China)

机构地区：[1]新乡医学院河南省人民医院,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》2025年第3期194-202,共9页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金面上项目(82171963,82371980);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;2024年度河南省医学科技攻关计划联合共建项目(LHGJ20240037)。

摘　　要：目的:应用24 MHz超高频超声探头与全息血管硬度分析(R-VQS)技术测量强直性脊柱炎(AS)患者颈动脉内膜(CIT)、硬度参数,并探讨其影响因素。方法:前瞻性收集2023年11月至2024年5月在河南省人民医院进行诊疗的60例AS患者作为AS组,纳入同期性别、年龄、体质指数与之匹配的54例健康志愿者作为对照组,应用24 MHz超高频超声探头测量CIT,应用R-VQS技术测量脉搏波传导速度(PWV)、硬度指数(HC),比较两组间参数差异。通过单因素、多因素线性回归分析进一步探讨AS患者颈动脉弹性和内膜厚度变化情况及其影响因素。结果:①与对照组相比,AS组C反应蛋白、红细胞沉降率(ESR)、中性粒细胞计数及中性粒细胞/淋巴细胞比值(NLR)升高,差异有统计学意义(均P<0.05)。②AS组CIT、颈动脉内中膜厚度(CIMT)、HC、PWV及心外膜脂肪组织厚度(EATT)较对照组增高,差异有统计学意义(均P<0.05)。③多因素线性回归分析显示EATT、ESR是HC、PWV、CIT的主要影响因素(β=2.192、0.031,1.792、0.002,0.097、0.001;均P<0.05)。结论:AS患者颈动脉CIT、CIMT、HC、PWV及EATT增大,ESR、EATT是HC、PWV、CIT的主要影响因素,提示临床进行干预时应更加关注AS患者ESR、EATT的检测。Objective:To evaluate the changes of carotid intima thickness(CIT)and stiffness parameters in ankylosing spondylitis(AS)patients by 24 MHz ultra-high frequency ultrasound probe and RF-data based quantitative analysis on vessel stiffness(R-VQS),and to explore its influencing factors.Methods:Sixty patients with AS who underwent consultation at Henan Provincial People's Hospital from November 2023 to May 2024 were prospectively collected as AS group,54 healthy volunteers matched for sex,age,and body mass index were collected as control group.CIT were measured using a 24 MHz ultra-high frequency ultrasound probe,hardness coefficien(HC)and pulse wave velocity(PWV)were measured by R-VQS,the differences of the parameters between the two groups were compared.The changes of carotid artery elasticity and intima thickness and their influencing factors in patients with AS were explored by univariate and multivariate linear regression analysis.Results:①C-reactiveprotein,erythrocyte sedimentation rate(ESR),neutrophil count and neutrophil to lymphocyte ratio(NLR)were elevated in the AS group compared with the control group,and the differences were statistically significant(all P<0.05).②CIT,carotid intima-media thickness(CIMT),HC,PWV and epicardial adipose tissue thickness(EATT)were all increased in the AS group compared with the control group,and the differences were statistically significant(all P<0.05).③Multifactorial linear regression analysis showed that EATT,ESR were the main influencing factors of HC,PWV and CIT(β=2.192,0.031;1.792,0.002;0.097,0.001;all P<0.05).Conclusions:Carotid CIT,CIMT,HC,PWV and EATT are all higher in the AS patients,and ESR and EATT are the main influencing factors of HC,PWV,and CIT,suggesting that more attention should be paid to the detection of ESR and EATT in patients with AS when interventions are performed clinically.

关 键 词：超高频超声 强直性脊柱炎 颈动脉弹性 颈动脉内膜厚度 心外膜脂肪组织厚度 

分 类 号：R593.23[医药卫生—内科学]