血管回声跟踪技术评价头颈部肿瘤患者放疗后颈动脉弹性

E-Tracking technique in assessment of carotid elasticity of the patients with head and neck tumor after radiotherapy

目的:应用E-Tracking技术探讨头颈部肿瘤患者放疗后颈动脉弹性功能变化及其临床意义。方法:收集75例放疗后头颈部肿瘤患者(放疗组)及65例健康志愿者(对照组),比较两组颈动脉的参数变化;选择放疗组39例患者比较放疗前与放疗后的颈动脉参数变化;E-Tracking参数包括僵硬度(β)、弹性模型(Eρ)、顺应性(AC)、脉搏波传导速度(PWVβ)及内-中膜厚度(IMT)。并对放疗组颈动脉损伤影响因素进行分析。结果:放疗组较对照组β、Eρ、PWVβ、IMT升高,AC降低,差异均有统计学意义(P<0.05)。与放疗前比较,放疗后β、Eρ、PWVβ值增高,AC降低,差异有显著性(P<0.05),IMT比较无显著性差异(P>0.05)。经多因素Logistic回归分析发现年龄>60岁、放疗间隔时间>5年是头颈部肿瘤患者放疗后颈动脉损伤的危险因素。结论 :头颈部肿瘤患者放疗后颈动脉弹性功能较正常人减低;E-Tracking参数能够早期反映颈动脉弹性功能的异常改变;年龄、放疗间隔时间是头颈部肿瘤患者放疗后颈动脉损伤的危险因素。

Objective： To explore the clinical value of E-Tracking technique in assessment of carotid elasticity of the pa- tients with head and neck tumor after radiotherapy. Methods： Seventy-five cases of head and neck tumor patients after radio- therapy （radiation group） and 65 cases of healthy volunteers （control group） were enrolled in this study and the parameters of the carotid artery of two groups were compared. For radiation group, the carotid artery parameters of 39 patients were com- pared before and after radiotherapy. E-Tracking parameters including carotid artery stiffness parameters （β）, pressure-strain e- lastic modulus（Ep）, compliance（AC）, pulse wave veloeity（PWVβ） and carotid artery intima-media thickness（IMT） were measured and recorded by E-Tracking technique. And the injury factors of carotid artery after radiotherapy were analyzed too. Results： Compared with control group, 6, Ep, PWVJ3, IMT in radiation group increased, AC decreased, the differences had the statisti- cal significance（all P〈0.05）. After radiotherapy, β, Ep, PWVβ increased, AC decreased（P〈0.05） compared with before radiother- apy in the radiation group, but IMT had no statistical significance （P〉0.05）. Logistic regression analysis showed that age（〉60 years）, time interval of radiotherapy（〉5 years） were the risk factors of carotid artery injury in patients with head and neck tu- mor. Conclusion： The carotid elasticity after radiotherapy in patients with head and neck tumor decreased compared with healthy subjects. E-Tracking parameters can reflect early the abnormal changes of carotid elasticity. Age, time interval of ra- diotherapy are the risk factors of carotid artery injury after radiotherapy for head and neck tumor patients.