彩色多普勒超声在评估非酒精性脂肪肝患者颈动脉病变中的应用价值

Application Value of Color Doppler Ultrasound in Evaluation of CAD in Patients with Non-Alcoholic Fatty Liver Disease

目的 探讨彩色多普勒超声在评估非酒精性脂肪肝（NAFLD）患者颈动脉病变中的应用价值。方法 选择2012年6月-2014年6月我院收治的189例NAFLD患者作为研究对象,根据患者脂肪肝病情严重程度分为轻度、中度及重度3组,每组均63例。所有患者均进行颈动脉彩色多普勒超声检查,并计算患者颈动脉内膜-中层厚度（IMT）、斑块检出率、收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV）及平均血流速度（MV）、阻力指数（RI）,比较不同组别各测量值的差异。结果 中度及重度组患者左右颈总动脉主干及膨大处的IMT高于轻度组,斑块检出率高于轻度组,PSV、EDV、MV低于轻度组,RI值高于对照组,且差异均具有统计学意义（P〈0.05）。重度组患者的IMT、RI值、斑块检出率高于中度组,PSV、EDV、MV低于中度组,且差异均具有统计学意义（P〈0.05）。脂肪肝程度与PSV、EDV、MV呈显著负相关,而与IMT、斑块检出率及RI值呈显著正相关。结论 颈动脉彩色多普勒超声可准确地评估NAFLD患者颈动脉病变程度,可为临床治疗方案的选择提供可靠的依据,具有一定的推广价值。

Objective To evaluate the application value of color Doppler ultrasound in evaluation of CAD（Carotid Artery Disease） in patients with NAFLD（Non-Alcoholic Fatty Liver Disease）. Methods Altogether 189 NAFLD patients who had been treated in the hospital from June 2012 to June 2014 were recruited in this study and divided evenly into three groups according to the severity of NAFLD： Mild Group, Moderate Group and Severe Group with each group 63 cases. Carotid artery color Doppler ultrasound was performed in three groups to calculate the IMT（Intima-Media Thickness）, the detection rate of plaques, PSV（Peak Systolic Velocity）, EDV（End Diastolic Velocity）, MV（Mean Velocity） and RI（Resistant Index）. Then, comparisons were made between the measurement results of three groups. Results The IMT and detection rate of plagues in the left and right common carotid artery trunk as well as the enlargement area in patients of Moderate Group and Severe Group were higher than Mild Group; while, PSV, EDV and MV in those groups were lower than Mild Group; RI was higher than Mild Group. Statistically significant differences existed between three groups（P〈0.05）. The IMT, RI and the detection rate of plaques in Severe Group were higher than those of Moderate Group; the PSV, EDV and MV in Severe Group were lower than those of Moderate Group with statistically significant differences（P0.05）. Negative correlation was revealed between the severity of NAFLD and PSV, EDV as well as MV. While, positive correlation was revealed between the severity of NAFLD and IMT, the detection rate of plagues as well as RI. Conclusion Application of carotid artery color Doppler ultrasonography could accurately evaluate the severity of CAD in patients with NAFLD, which provided reliable references for selection of clinical treatment and deserved to be applied.