超声血管弹性定量技术早期评价HIV感染人群动脉粥样硬化的可行性研究

Feasibility study of early evaluation of atherosclerosis in HIV-infected patients by ultrasound vascular stiffness quantitative technique

目的应用超声血管弹性定量技术(ultrasound quantitative artery stiffness technique)对健康人群和HIV感染不同人群的颈动脉弹性定量参数评估,探讨其在无创评估HIV患者动脉粥样硬化临床前期动脉弹性的可行性。方法受试者分为3组:健康对照组(n=38);新发HIV感染患者,即HIV基线组(n=55);接受高效抗反转录病毒治疗(Highly Active Antiretroviral Therapy,HAART)超过5年的HIV感染患者,即HAART组(n=40);对所有受试者颈动脉进行超声血管弹性成像,获取右侧颈动脉内中膜厚度(Intima-media thickness,IMT)、血管运动幅度、血管硬度系数和单点脉搏波传导速度(Pulse Wave Velocity,PWV)结果,并进行组间比较。对HAART人群采用传统的压力波方法测量肱-踝脉搏波传导速度(Brachial-ankle Pulse Wave Velocity,baPWV),将两种方法获取的动脉PWV结果进行相关性分析。结果健康对照组、HIV基线组和HAART组的颈动脉IMT之间的差异无统计学意义。3组人群颈动脉运动幅度之间的差异有统计学意义(P<0.05),其中对照组结果最大,HAART组结果最小。3组人群颈动脉硬度系数之间的差异有统计学意义(P<0.05),其中对照组结果最小,HAART组结果最大。3组人群颈动脉PWV之间的差异有统计学意义(P<0.05),其中对照组结果最小,HAART组结果最大。HAART人群的右侧颈动脉PWV与右侧baPWV结果相关系数为0.60,左侧颈动脉PWV与左侧baPWV结果相关系数为0.57。结论超声血管弹性定量技术可以早期识别HIV人群动脉粥样硬化临床前期的血管弹性变化。

Objective To explore the feasibility of non-invasive assessment of AS in patients with HIV,the stiffness of carotid artery in healthy controls and HIV-infected patients were tested using ultrasound quantitative artery stiffness technique.Methods The subjects were divided into three groups,controls(n=38),baseline-HIV(n=55)and HAART-HIV(n=40).The ultrasound analysis of vascular stiffness was performed in all subjects to measure the intima-media thickness(IMT)of right carotid,the displacement of vessel,the vascular stiffness coefficient and the pulse wave velocity(PWV).The measurements obtained were compared between groups.In HAART-HIV group,Brachial-ankle Pulse Wave Velocity(baPWV)was measured by traditional pressure wave method,and the results of arterial PWV measured by two methods were analyzed by correlation.Results There was no significant difference in IMT among control,baseline-HIV and HAART-HIV groups.However,the displacement of carotid artery movement among the three groups was found to be significantly different(P<0.05),with the control group and the HAART-HIV group having the highest and the lowest displacement,respectively.The carotid artery stiffness coefficient was also significantly different(P<0.05)among the three groups,with the control group and the HAART-HIV group showing the lowest and the highest level of stiffness,respectively.For carotid artery,there was a significant difference(P<0.05)in the PWV among the three groups,with the control group being the lowest and HAART-HIV group being the highest in velocity.The correlation coefficient between the right carotid artery PWV and the right baPWV was 0.60,while for that of between the left carotid artery PWV and the left baPWV was 0.57.Conclusion The ultrasound analysis of vascular elasticity is a viable technique for the identification of preclinical changes of atherosclerosis in HIV population.