血管回声跟踪技术评价甲状腺功能减退症临床型及亚临床型患者颈动脉弹性

Assessment on carotid artery elasticity in patients with clinical and subclinical hypothyroidism by using echo-tracking technique

目的应用血管回声跟踪(ET)技术定量评价甲状腺功能减退症临床型(甲减)及亚临床型(亚甲减)患者颈动脉弹性的变化。方法选择甲减患者25例,亚甲减患者25例及25名健康者(对照组),用二维超声测量双侧颈总动脉内-中膜厚度(IMT),应用ET技术检测双侧颈总动脉的僵硬度指数(β)、血管压力-应变弹性系数(Ep)、动脉顺应性(AC)、增大指数(AI)及脉搏波传导速度(PWVβ)。结果与对照组比较,甲减患者β、Ep、PWVβ增高,亚甲减患者β及Ep增高,AI降低(P<0.05),余差异无统计学意义;甲减与亚甲减患者的IMT及ET参数比较差异均无统计学意义(P均>0.05)。IMT与β、Ep及PWVβ呈正相关(P<0.01),与AC、AI无相关性(P>0.05);年龄与IMT、β、Ep及PWVβ呈正相关(P<0.01),与AC呈负相关(P<0.01),与AI无相关性(P>0.05)。结论颈动脉弹性的降低与甲状腺功能的减退及年龄增长有关,且其弹性下降先于颈动脉形态学改变。ET技术可以快速、无创地评价甲状腺功能减退症患者颈动脉弹性。

Objective To evaluate the carotid artery elasticity in patients with clinical and subclinical hypothyroidism patients by using echo-tracking （ET） technique. Methods Twenty-five patients with clinical hypothyroidism, 25 with subclinical hypothyroidism and 25 healthy subjects （control group） were enrolled. The intima-media thickness （IMT） of carotid arteries were measured with two-dimensional ultrasound. The stiffness parameter （β）, pressure-strain elasticity modulus （Ep）, arterial compliance （AC）, argumentation index （AI） and one point pulse wave velocity （PWVβ） of the arteries were automatically measured by ET technique. Results Compared with control group, β, Ep and PWVβ were higher in the clinical hypothyroidism group, β, Ep were higher and AI was lower in the subclinical hypothyroidism group （P〈0.05）. There was no difference of IMT nor ET parameters between cliaical hypothyroidism group and subclinical hypothyroidism group （P〈0.05）. IMT was positively correlated with β, Ep and PWVβ （P〈0.01）, but not with AC and AI （P〈0.05）. Age was positively correlated with IMT, β, Ep and PWVβ（P〈0.01）, negatively correlated with AC （P〈0.0I）, but not correlated with AI （P〈0.05）. Conclusion The decrease of carotid artery elasticity is related to dysfunction of thyroid and the increase of age. ET technique provides a quick, non-invasive method to assess carotid elasticity in patients with hypothy- roidism.