超声射频技术随访评估中青年高胆固醇血症患者颈动脉结构和弹性功能

Follow-up evaluation of carotid artery structure and elasticity function in patients with hypercholesterolemia by ultrasound radio frequency technique

目的探讨超声射频信号定量技术无创性随访观察中青年高胆固醇血症患者干预治疗前、后颈总动脉内中膜厚度(intima-media thickness,IMT)和弹性功能变化。方法收集血清总胆固醇(total cholesterol,TC)浓度增高而三酰甘油(triacylglycerol,TG)浓度正常的中青年患者120例,其中58例患者进行他汀类药物治疗作为药物组,其余62例患者未行降血脂药物治疗,仅改变饮食习惯、生活方式,为对照组。应用超声射频技术对所有参与者的左侧颈总动脉进行检查,获得颈动脉IMT、顺应性系数(compliance coefficient,CC)、僵硬度指数(β)、脉搏波传导速度(pulse wave velocity,PWV),并进行统计学分析。结果所有患者干预后TC、β、PWV较治疗前降低,CC升高,差异均有统计学意义(均P<0.05)。药物组治疗后颈总动脉IMT较治疗前降低,差异有统计学意义(P<0.05);而对照组颈总动脉IMT较治疗前有降低趋势,但差异无统计学意义(P>0.05)。干预后药物组的IMT较对照组降低,差异有统计学意义(P<0.05);而两组的TC、β、PWV、CC比较,差异无统计学意义(P>0.05)。结论超声射频技术能够无创性定量随访观察高胆固醇血症患者颈总动脉IMT和弹性功能早期变化,有望成为临床评价高胆固醇血症患者干预后疗效的有效手段。

Objectives To evaluate carotid artery intima-media thickness （IMT） and elastic function in young and middle-aged patients with hypercholesterolemia before and after treatment by ultrasound radio frequency technique. Methods Totally 120 young and middle-aged patients with hypercholesterolemia and without hypertriglyceride were selected in this study. Among them, 58 patients were in drug group who using statin therapy, the other 62 patients were in control group who changing dietary habits and lifestyle without drugs. Common carotid artery IMT, compliance coefficient （CC）, stiffness parameter （β）, pulse wave velocity （PWV） were monitored from left common carotid artery of the patients by ultrasound radio frequency technique, and were statistically analyzed. Results Total cholesterol （TC）, β, PWV of the patients reduced, CC increased after intervention, the differences were statistically significant （ all P〈0.05 ）. Carotid artery IMT of drug group after treatment was lower than that before treatment, the difference was statistically significant（P〈0.05 ） ; carotid artery IMT of control group reduced after treatment when compared with before intervention, but the difference was no statistical significance （P〉0.05）. IMT of drug group were lower than that of control group after intervention, the difference was statistically significant （P〈0.05）, but there were no statistical significances of TC, β ,PWV and CC between the two groups （P〉0.05）. Conclusions Ultrasonic radio frequency technique could follow up the changes of hypereholesterolemia patients＇ common carotid artery IMT and elasticity, which could become a valuable method for evaluating early structural and arterial functional change of the carotid artery in hypercholesterolemia patients.