45岁以下人群颈动脉粥样硬化病变的筛查和危险因素分析

Screening of carotid atherosclerosis in a population less than 45 years of age using color Doppler ultrasonography and the analysis of major risk factors

目的利用彩色多普勒血流显像（CDFI）分析45岁以下人群早期颈动脉粥样硬化（CAS）的检出率及危险因素。方法对25～34岁和35～44岁两个年龄组各459例的体检人员行颈动脉超声检查，测量双侧颈总动脉远段、颈动脉分叉处及颈内动脉起始段内-中膜厚度（IMT）和是否存在粥样硬化斑块，以IMT增厚与否分为病变组（CAS组）和正常组。并对两组的危险因素进行比较结果①CAS组117例，平均年龄（41±5）岁；正常组801例，平均年龄（36±5）岁，两组年龄比较，差异有统计学意义（P〈0．05或P〈0．01）。②CAS组高血压、高脂血症、高血糖、肥胖发生率分别为23．1％、24．8％、16．2％和34．2％；正常组为15．1％，13．2％，8．7％和21．1％，两组比较差异均有统计学意义。③25～34岁组CAS检出率为5．23％（24／459），35～44岁组为20．26％（93／459），两组比较差异有统计学意义（P〈0．01）。发生CAS患者中，25～34岁组病变程度较轻，全部为单纯IMT增厚，而35～44岁组则有20．4％（19／93）已形成粥样斑块（P〈0．05）。结论与25～34岁组比较，35～44岁年龄组CAS颈动脉粥样硬化病变发生率高、程度重；CDFI可以为45岁以下人群颈动脉脉粥样硬化的早期诊治和预防提供客观依据。

Objective To analyze the detection rate and risk factors of early carotid atherosclerosis （CAS） in a population less than 45 years of age by using color Doppler flow imaging （CDFI）. Methods Carotid uhrasonography was performed in 459 subjects from 25 to 34 years and 459 subjects from 35 to 44 years. The intima-media thickness （IMT） of distal segments of bilateral common carotid arteries, carotid bifurcation and the origin of the internal carotid artery, as well as the atherosclerotic plaque were measured. The patients were divided into CAS group and normal group according to whether they had ITM thickening, and their major risk factors were investigated and analyzed Results ①There were 117 patients in the CAS group, and their mean age was 41±5 years; 801 patients in the normal group, and their mean age was 36±5 years. There were statistically differences in age between the 2 groups. ②The incidences of hypertension, hyperlipemia, hyperglycemia and obesity in the CAS group were 23.1%, 24. 8%, 16.2%, and 34. 2%, respectively; and the incidences in the normal group were 15. 1%, 13.2%, 8.7%, and 21.1%, respectively. There were statistically differences between the 2 groups. ③Thedetection rate of CAS in the 25 -34 years and 35 -44 years groups were 5.23% （24/459） and 20. 26% （93/459）, respectively. There were statistically differences between the both groups （P 〈 0. 01 ）. Of the patients who had CAS, the lesion was mild in the 25 - 34 years group. They had intimamedia thickening only. While 20. 4% patients （ 19/93 ） in the 35 - 44 years group, the atherosclerotic plaques were already formed（ P 〈 0. 05 ）. Conclusions As compare with the population of 25 -34 years old, the incidence of CAS is higher and more severe in the 35 - 44 years old population ; Color Doppler ultrasonography may provide an objective basis for early diagnosis and prevention of CAS in the young adult population.