CAJ | 학술논문

目的评价下肢动脉粥样硬化性疾病(LEAD)患者股总动脉、颈总动脉的形态与功能重构特征.方法选取31例LEAD患者与34例健康对照者,应用超声射频血管内中膜定量分析(QIMT)和动脉僵硬度定量分析(QAS)技术测量双侧股总动脉与颈总动脉内中膜厚度(IMT)、管腔内径(D)、局部僵硬度参数(β和PWVβ),并分析影响LEAD患者股动脉僵硬度的相关因素.结果 ①LEAD组收缩压(SBP)、脉压(PP)、吸烟量及吸烟程度均高于对照组(P＜0.05).②与对照组比较,LEAD组双侧股总动脉的IMT显著增厚,内中膜厚度与管径比值(IMT/D)明显增大,差异有统计学意义(P＜0.01).左侧颈总动脉IMT显著增厚(P＜0.05),右侧颈总动脉IMT稍增厚(P=0.06);双侧颈总动脉内径(D)显著增宽(P＜0.01).LEAD患者双侧颈总动脉、股总动脉平均IMT(mIMT)显著增厚(P＜0.05).左侧颈总动脉局部僵硬度参数(β)及双侧颈总动脉局部脉搏波传导速度(PWVβ)显著增高,双侧股动脉β、PWVβ测值均显著增高(P＜0.05).双侧颈总动脉、股总动脉平均β(mβ)、PWVβ(mPWVβ)增高(P＜0.01).颈总动脉与股总动脉局部僵硬度指标间呈显著正相关(P＜0.01).③股动脉mβ及mPWVβ与mIMT、SBP、吸烟量及吸烟程度呈正相关,股动脉mPWVβ与年龄呈正相关(P＜0.05).逐步多元线性回归显示:mIMT、PP是股动脉mβ的独立相关因素;SBP、吸烟程度及mIMT是股动脉mPWVβ的独立相关因素.结论 LEAD患者的外周动脉发生血管重构,股动脉及颈动脉僵硬度明显增高,以股动脉更显著.下肢动脉僵硬度与内中膜厚度、动脉血压及吸烟程度有关.
목적 평개하지동맥죽양경화성질병(LEAD)환자고총동맥、경총동맥적형태여공능중구특정.방법 선취31례LEAD환자여34례건강대조자,응용초성사빈혈관내중막정량분석(QIMT)화동맥강경도정량분석(QAS)기술측량쌍측고총동맥여경총동맥내중막후도(IMT)、관강내경(D)、국부강경도삼수(β화PWVβ),병분석영향LEAD환자고동맥강경도적상관인소.결과 ①LEAD조수축압(SBP)、맥압(PP)、흡연량급흡연정도균고우대조조(P＜0.05).②여대조조비교,LEAD조쌍측고총동맥적IMT현저증후,내중막후도여관경비치(IMT/D)명현증대,차이유통계학의의(P＜0.01).좌측경총동맥IMT현저증후(P＜0.05),우측경총동맥IMT초증후(P=0.06);쌍측경총동맥내경(D)현저증관(P＜0.01).LEAD환자쌍측경총동맥、고총동맥평균IMT(mIMT)현저증후(P＜0.05).좌측경총동맥국부강경도삼수(β)급쌍측경총동맥국부맥박파전도속도(PWVβ)현저증고,쌍측고동맥β、PWVβ측치균현저증고(P＜0.05).쌍측경총동맥、고총동맥평균β(mβ)、PWVβ(mPWVβ)증고(P＜0.01).경총동맥여고총동맥국부강경도지표간정현저정상관(P＜0.01).③고동맥mβ급mPWVβ여mIMT、SBP、흡연량급흡연정도정정상관,고동맥mPWVβ여년령정정상관(P＜0.05).축보다원선성회귀현시:mIMT、PP시고동맥mβ적독립상관인소;SBP、흡연정도급mIMT시고동맥mPWVβ적독립상관인소.결론 LEAD환자적외주동맥발생혈관중구,고동맥급경동맥강경도명현증고,이고동맥경현저.하지동맥강경도여내중막후도、동맥혈압급흡연정도유관.
Objective To assess the peripheral arterial structural and elastic remodeling in patients with lower extremity atherosclerotic disease (LEAD).Methods Thirty-one patients with LEAD and 34 age-,sex-matched healthy subjects (control group) were enrolled in this study.The intima-media thickness (IMT),diameter (D) and parameters of arterial stiffness (β,pulse wave velocity (PWVβ)) were measured by acquiring the longitudinal view of left and right common femoral artery (LCFA,RCFA) and common carotid artery (LCCA,RCCA) by quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) techniques.The factors correlated with arterial stiffness in LEAD patients were analyzed.Results ① The systolic blood pressure(SBP),pulse pressure(PP),smoking pack-year and smoking extent (nonsmoker,smoker with ＜40 pack-year,or smoker with ≥40 pack-year) were significantly higher in LEAD group than those in the control group (P ＜0.05).②IMT of the LCCA and the diameters (D) of LCCA and RCCA were significantly increased in the LEAD group (P ＜0.05-0.01).As to the both sides CFA,IMT and IMT/D values were significantly increased (P ＜ 0.01).The mean IMT (mIMT) of both sides of CCA and CFA were increased (P ＜0.05).The values of β,PWVβ of LCCA and PWVβ of RCCA were significantly increased,and β and PWVβ values of both sides of CFA were significantly increased in the LEAD group (P ＜ 0.05).There was a positive correlation between the stiffness indexes of the carotid artery and that of the femoral artery (P ＜0.01).③The femoral mβ was correlated with femoral mIMT,SBP,PP,smoking amount and smoking extent,and the femoral mPWVβ was also correlated with mIMT,age,SBP,PP,smoking pack-year and smoking extent (P ＜0.05-0.01).In multivariable stepwise regression analysis,mIMT and PP were factors independently correlated with femoral mβ.And SBP,smoking extent,and mIMT were independently correlated with femoral mPWVβ.Conclusions Peripheral arteries in patients with LEAD experience vascular remodeling,as well as increased carotid and femoral stiffness.Femoral stiffness is correlated with IMT,arterial blood pressure and smoking extent.