颈动脉斑块的生长与血流动力学参数以及内中膜厚度之间的关系研究

Correlation among plaque growth,hemodynamic parameters and intima-media thickness in carotid artery

目的:分析颈总动脉(CCA)斑块的生长与血流动力学参数以及动脉内中膜厚度(IMT)之间的关系。方法:选取在镇平县人民医院、河南电力医院行颈动脉彩色多普勒超声检查的17 763例受检者,按检查结果分为CCA有斑块与无斑块组、IMT增厚与正常组,对比各组之间的血流动力学参数:收缩期峰值流速(PSV)、舒张末期流速(EDV)、搏动指数(PI)、阻力指数(RI)以及收缩期峰值流速和舒张末期流速比值(PSV/EDV)。结果:颈总动脉斑块形成以及IMT增厚均以双侧受累最常见,单侧表现为左侧多于右侧。相对于CCA无斑块组和IMT正常组,CCA有斑块组和IMT增厚组的PSV、EDV显著降低而PI、RI及PSV/EDV显著增高;同时单侧斑块形成或单侧IMT增厚组的PSV、EDV显著高于双侧斑块形成或双侧IMT增厚组,而PI、RI及PSV/EDV均显著低于双侧斑块形成或IMT增厚组,均P<0.05。结论:颈动脉斑块生长与IMT增厚均以双侧受累最为常见,且双侧颈动脉均有斑块形成和IMT增厚时,血流动力学参数的改变最为明显。

Objective： To analyze the relationship among plaque growth,hemodynamic parameters and intima-media thickness（IMT） in common carotid artery（CCA）.Methods： 17 763 cases who were given carotid artery color Doppler ultrasound examination according to the results were divided into CCA plaque group and non-plaque group,IMT thickened group and IMT normal group.Hemodynamic parameters including systolic maximum velocity（PSV）,end diastolic flow velocity（EDV）,pulsatility index（PI）,resistance index（RI） and systolic peak velocity and diastolic velocity ratio（PSV/EDV） were compared between the groups.Results： The common carotid artery plaque formation and thickening of IMT with bilateral involvement was the most common manifestation,unilateral left more than right.Compared with CCA non-plaque group and normal IMT group,PSV and EDV of CCA plaque group and IMT thickened group were significantly decreased,PI,RI and PSV/EDV increased significantly.PSV and EDV of unilateral plaque formation or unilateral thickening of IMT group were significantly higher than those of bilateral plaque formation or thickening of IMT group,while PI,RI and PSV/EDV were significantly lower,all P0.05.Conclusion： Most of subjects with plagues and thickened IMT were bilateral,and bilateral carotid artery plaque formation and thickened IMT,the hemodynamic parameters of the most obvious change.