中年男性高脂蛋白血症患者颈动脉管壁内膜-中膜厚度的研究

Intima media thickness of carotid arteries in male middle aged subjects with hyperlipoproteinemia

目的评价男性高脂蛋白血症（ＨＬＰ）患者动脉粥样硬化（ＡＳ）的发病情况。方法利用高分辨超声（ＨＲＵＳ）直接测量颈动脉系管壁内膜－中膜厚度（ＩＭＴ）和内径。８２例研究对象，年龄４５～６４岁，分为正常组（Ⅰ）、无症状ＨＬＰ组（Ⅱ）和ＨＬＰ伴心血管病变组（Ⅲ）。用ＨＲＵＳ分别检测颈总、颈内动脉及颈动脉球部后壁ＩＭＴ、内径及最大血流速度。结果无症状ＨＬＰ患者颈总动脉、颈动脉球部ＩＭＴ较正常人明显增高（Ｐ＜０．０００５），随着血脂升高并出现临床症状，ＩＭＴ增加更明显（Ｐ＜０．０２５）。结论颈动脉球部ＩＭＴ增高较颈总、颈内动脉ＩＭＴ明显（Ｐ＜０．０１），是评价ＡＳ变化最敏感的部位。

Objective To assess the extent of atherosclerosis(AS) of carotid arteries in male middle aged subjects with hyperlipoproteinemia (HLP). Methods Directly detecting intima media thickness (IMT) with noninvasive high resolution ultrasound (HRUS). Results Far wall IMTs of common carotid arteries and carotid bulb in asymptomatic HLP patients are higher than those in normal sujects (P<0.0005). In HLP patients with clinical symptoms, IMTs increase much more obviously (P<0.025). Conclusions IMTs in carotid bulb are more sensitive in atherosclerotic changes than those in common and internal carotid arteries (P<0.01). The ratio of IMT/diameter shows similar tendency. Diameter and peak systolic velocity in carotid arteries do not appear valuable.