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目的 :应用高频超声技术评价颈动脉粥样硬化血管重构改变 ,探讨血管重构的影响因素。方法 :在1 0 7例颈动脉粥样硬化斑块形成患者 ,应用高频超声测量血管总面积 (TVA)、管腔面积 (LA)、斑块面积 (PA)、面积狭窄率 (S)、偏心指数 (EI)和重构指数 (RI) ,并检测空腹血糖 (BS)、血清总胆固醇 (TC)、甘油三酯(TG)、一氧化氮 (NO)和内皮素 (ET)。结果 :正性重构组 TVA、 LA均显著大于负性重构组 (P<0 .0 5) ,正性重构组 TVA与 PA呈高度相关 (r=0 .84) ,无重构组、负性重构组 TVA与 PA呈中度相关 (r分别为 0 .65,0 .67) ;斑块部位 TVA与 PA呈正相关 (r=0 .77) ,LA与 PA无相关性。软斑组 RI大于硬斑组和钙化斑组 (P<0 .0 5)。糖尿病组 RI小于无糖尿病组 (P<0 .0 0 1 )。向心性斑块组 TC和 ET高于偏心性斑块组 (P<0 .0 0 1 )。舒张压与 TVA呈负相关 (r=- 0 .2 4 )。 ET与 PA及 S呈正相关 (r分别为 0 .52 ,0 .40 )。高密度脂蛋白胆固醇(HDL)与 TVA呈弱正相关 (r=0 .34)。结论 :应用高频超声技术可评价颈动脉粥样硬化血管重构现象 ,糖尿病、年龄、血压、 TC、 TG、 HDL和 ET与血管重构有关
Objective: To evaluate the changes of vascular remodeling in carotid atherosclerosis by high frequency ultrasound and to explore the influencing factors of vascular remodeling. Methods: A total of 107 patients with carotid atherosclerosis plaque were enrolled in this study. High-frequency ultrasound was used to measure the total vessel area (TVA), lumen area (LA), plaque area (PA), stenosis area (EI) and remodeling index (RI). Fasting blood glucose (BS), total cholesterol (TC), triglyceride (TG), nitric oxide (NO) and endothelin (ET) were measured. Results: The TVA and LA of the positive remodeling group were significantly higher than that of the negative remodeling group (P <0.05), and the TVA of the positive remodeling group was highly correlated with PA (r = 0.84) , TVA was negatively correlated with PA (r = 0.65,0.67, respectively). There was a positive correlation between TVA and PA in plaque (r = 0.77). There was no correlation between LA and PA. RI in the soft spot group was higher than that in the hard spot group and calcified plaque group (P <0.05). RI in diabetic group was less than that in non-diabetic group (P <0.01). TC and ET in the central plaque group were higher than those in the eccentric plaque group (P <0. 001). Diastolic pressure was negatively correlated with TVA (r = - 0.24). ET was positively correlated with PA and S (r = 0.52, 0.40, respectively). High-density lipoprotein cholesterol (HDL) was positively correlated with TVA (r = 0.34). Conclusions: The phenomenon of carotid atherosclerosis remodeling can be evaluated by high-frequency ultrasound. Diabetes mellitus, age, blood pressure, TC, TG, HDL and ET are associated with vascular remodeling