CAJ | 학술논문

目的推导颈动脉弹性传递指数(CETI),并将该指数与原发性高血压患者颈动脉内中膜厚度(IMT)进行关联分析,探讨CETI的临床应用价值.方法选择77例原发性高血压患者与24名同期体检正常非高血压者,应用多普勒超声检测颅内动脉的血流速度,计算其搏动指数(pI),同时采用双功能彩色多普勒超声检测颈动脉IMT及颈总动脉的血流速度,计算其PI值:推导出公式CET11=大脑中动脉PI/颈总动脉PI、CETI2=颈内动脉颅外段PI/颈总动脉PI、CETI3=基底动脉PI/颈总动脉PI,应用曲线拟合,分析CETI与IMT的关联性.应用多元逐步回归分析筛选反映IMT、CETI变化较敏感的因素.结果 CETI1、CETI2和CETI3三者与IMT均呈曲线关系,决定系数r2分别为0.665、0.601、0.573,二次方程依次为Y1=0.504+0.049x+0.203x2,r=0.815,P=0.000;y2=1.009-1.141x+0.891x2,r=0.775,P=0.000;y3=0.775-0.687x+0.641x2,r=0.756,P=0.000),其中CETI1与IMT间曲线关联性最显著.高血压患者颈动脉IMT与LDL-C、每日吸烟量、SBP、年龄有线性回归关系;CETI1与SBP及每日吸烟量有线性回归关系;CETI2与BMI、SBP有线性回归关系:CETI3与SBP、CHOL及每日吸烟量有线性回归关系.结论本研究推导的CETI随IMT的增厚而增大,提示在高血压患者颅内动脉和颈内动脉弹性储备的下降及当IMT增厚到一定程度,颅内动脉粥样硬化的速率较颤总动脉来的快,且影响CETI的危险因素与IMT相似.
목적 추도경동맥탄성전체지수(CETI),병장해지수여원발성고혈압환자경동맥내중막후도(IMT)진행관련분석,탐토CETI적림상응용개치.방법 선택77례원발성고혈압환자여24명동기체검정상비고혈압자,응용다보륵초성검측로내동맥적혈류속도,계산기박동지수(pI),동시채용쌍공능채색다보륵초성검측경동맥IMT급경총동맥적혈류속도,계산기PI치:추도출공식CET11=대뇌중동맥PI/경총동맥PI、CETI2=경내동맥로외단PI/경총동맥PI、CETI3=기저동맥PI/경총동맥PI,응용곡선의합,분석CETI여IMT적관련성.응용다원축보회귀분석사선반영IMT、CETI변화교민감적인소.결과 CETI1、CETI2화CETI3삼자여IMT균정곡선관계,결정계수r2분별위0.665、0.601、0.573,이차방정의차위Y1=0.504+0.049x+0.203x2,r=0.815,P=0.000;y2=1.009-1.141x+0.891x2,r=0.775,P=0.000;y3=0.775-0.687x+0.641x2,r=0.756,P=0.000),기중CETI1여IMT간곡선관련성최현저.고혈압환자경동맥IMT여LDL-C、매일흡연량、SBP、년령유선성회귀관계;CETI1여SBP급매일흡연량유선성회귀관계;CETI2여BMI、SBP유선성회귀관계:CETI3여SBP、CHOL급매일흡연량유선성회귀관계.결론 본연구추도적CETI수IMT적증후이증대,제시재고혈압환자로내동맥화경내동맥탄성저비적하강급당IMT증후도일정정도,로내동맥죽양경화적속솔교전총동맥래적쾌,차영향CETI적위험인소여IMT상사.
Objective To deduce carotid elasticity transmission index (CETI) and explore the correlation between CETI and intima-media thickness (IMT) of the carotid artery to investigate the clinical value of CETI. Methods Seventy-seven patients with essential hypertension (EH) and 24 healthy controls were collected. Their blood flow rate of cerebral arteries was detected by transcranial Doppler (TCD) and the pulsatility index (PI) was calculated. Their IMT and blood flow rate of common carotid artery (CCA) were detected by difunctional color Doppler; and then, their PI was calculated to analyze the correlation between CETI and IMT by curve fitting. The formulas were determined as: CETI1=PIMCA/PICCA, CETI2=PHCA/PICCA and CETB=PIBA/PICCA. Multiple stepwise regression analysis was employed to reflect the sensitive factors of IMT and CETI. Results Curvilinear correlation (curve of quadratic equation) was noted between CETI, including CETI1, CETI2 and CETI3, and IMT; each of the determination coefficient was r2=0.665, 0.601 and 0.573, respectively. Quadratic equations were y1=0.504+0.049x+0.203x2, r=0.815, P=0.000; y2= 1.009-1.141x+0.891x2, r=0.775, P= 0.000; y3=0.775-0.687x+0.641x2, 7=0.756, P=0.000. Among them, the correlation between CETI1 and IMT was the most significant. Linear regression was noted between IMT and LDL-C, daily dosage of smoking, SBP and gender. Linear regression was noted between CETT1 and both SBP and daily dosage of smoking. Linear regression was noted between CETI1 and both SBP and daily dosage of smoking. Linear regression was noted between CETI3 and SBP, CHOL and daily dosage of smoking. Conclusions CETI increases with the increase of IMT, suggesting that the rate of cerebral atherosclerosis is faster than the one of carotid in hypertensive patients when the elastic reserve of intracranial carotid artery and cerebral arteries decreases and the thickness of IMT increases to a certain extent. The risk factors of CETI are similar to IMT.