颈动脉内膜中层厚度与心血管危险因素聚集性的关系

Study on the Relationship between Carotid Intima-Media Thickness and Cardiovascular Risk Factor Clustering in Middle-aged Citizens

目的:通过对颈动脉IMT(颈动脉内中膜厚度intima-media thickness)和粥样斑块进行超声检测,分析心血管危险因素聚集性与颈动脉粥样硬化的关系.方法:227例受检者,男139例,女88例,年龄45～57岁(平均53.25±3.01岁).大部分受检者有多重危险因素但临床上无严重动脉粥样硬化疾病并以药物治疗为主.1.记录身高、体重、腰围及血压、空腹血糖、血脂,吸烟史及家族史.2.颈动脉彩色多普勒超声检查:分别测量颈总动脉、颈动脉膨大处,颈内动脉取平均IMT.3.根据颈动脉超声结果分组,正常对照组,IMT增厚组,斑块形成组.4.冠心病危险因素按国际标准确定:危险因素评分范围为0～5,以危险因素评分≥2定义为危险因素聚集.结果:1.各组间心血管危险因素水平的比较 :三组有统计学意义(P＜0.05).并且随血压、血糖、胆固醇、腰围水平升高,随LDL-L下降,颈动脉(IMT)加重.2.各组间心血管危险因素异常检出率比较:高血压、高血糖、高胆固醇血症、高LDL-C血症组间比较有统计学意义(P＜0.05),随颈动脉IMT加重,高血压、高血糖、高胆固醇血症、高LDL-C血症异常检出率明显升高.3.各组心血管危险因素积分比较:根据心血管危险因素积分按等级检验进行秩和检验(H=20.16,P＜0.05),并且随IMT增厚,危险因素积分逐渐升高.4.颈动脉IMT与心血管危险因素的相关分析:在双变量Spearsman相关分析中,颈动脉内中膜厚度与各危险因素及危险因素评分呈显著相关(P＜0.05),在调整性别、年龄进行偏相关分析中,IMT与舒张压、HDL-C的相关性无统计学意义(P＞0.05),与FBG、SBP、TC、TG、LDL-C、RFS存在显著相关性(P＜0.01).IMT与危险因素评分的相关系数分别为0.407与0.219.结论:心血管危险因素的聚集,提示颈动脉粥样硬化程度严重,预示颈动脉粥样硬化病变与多种心血管危险因素的聚集有显著相关性.

Objective： To analyze the relationship between multiple cardiovascular risk factors and carotid IMT by using ultrasonography method. Methods： 227 subjects within average 53.25 ± 3.01 years old were enrolled （139males, 88 females）. The trained persons investigated and measured their height, weight , blood pressure,BMI, fasting blood glucose,lipid profile and carotid ultrasonography. The subjects were divided into three groups. The risk factor score（RFS） range was 0 to 5. Cardiovascular risk factors included hypertention,diabete, abnormal lipid profile. The family history of cardiovascular disease （male 〈55years of age, female〈65years of age）,smoking and obesity. SPSS10.0 software was available to statistical analysis. Results： 1. he comparision among three groups was statistical significan. （P〈0.05）. And the levels of. WC. SBP. TC. LDL-L. FBG. and smoking index were accompanied with the impairment process of carotid artery IMT. 2. There were statistical significances for the data（P〈0.05）. The ratio of hypertention, diabetes, high blood TC and high blood LDL-L tended to increase with the development between carotid IMT. 3. Risk factor scores increased with the process of carotid IMT. 4. The correlation analysis between carotid intima-media thickness and cardiovascular risk factors was done as well. Conclusion： clustering of multiple cardiovascular risk factors can cause more severe atherosclerosis of carotid artery. B-mode ultrasound is helpful for early detection of large arterial damage.