射频超声技术评价冠心病患者颈动脉弹性的临床研究

摘要

Objective To investigate the value of ultrasound radio -frequency (RF) data technique in assessing carotid artery elasticity and its relationship with the coronary artery pathology in patients with coronary artery disease ( CAD). Methods A total of 127 patients with suspected CAD were enrolled in this study and they were divided into non CAD group ( group A:control group ) , atherosclerosis group ( group B ) , single artery involved (group C) and multi-arteries involved (group D) groups according to the severity of coronary arterial stenosis defined by coronary angiography(CAG). All patients received ultrasound RF-data technique examination on the carotid artery . The following elastic parameters : intima-media thickness (IMT) , stiffness parameter (α) , stiffness parameter (β) , pulse wave velocity ( PWV ) , distention coefficient ( DC ) , compliance coefficient ( CC) were obtained. The correlation of them and the differences among the four groups were analyzed. Results IMT in group A,B,C and D were(586. 250 ± 124. 12) , (586. 567 ± 128. 21) , (626.432 ± 124. 51) , ( 691. 033 ± 132. 01) (Jim resperitively, There were statistical different among the groups(F = 3. 923,P <0. 05). Compared group A with group B ,C and D,there were statistical differences (t =2.404,3.171,2.061,all P <0.05) ;PWV in group A,B,C and D were(7.561 ± 1.411), (7.742 ± 1.715) , (9.014 ±2. 339), (9.420 ±2. 624) m/s, There were statistical differences among the groups (F =4. 175, P<0.01). Compared group A,B with group C,there were statistical differences (t =1.996, 2.343,all P<0.05). Compared group A, B with group D, there were statistical differences (j=2.471,2.917,all/><0.05); DC in groupA,B,C and D were(0.021 ±0.010), (0.018 ±0.009), (0.015 ±0. 007), (0.013 ±0. 007)l/kPa, There were statistical difference among the groups (F = 3.740,P <0. 05) ,Compared group A with group C , there was statistical differences (t= 3. 089, P < 0. 05 ). Compared group A with group B and D , there were statistical differences(t =2.761,2.416,all P<0.05);CC in group A,B,C and D were (1. 141 ±0.620), (0.997 ±0. 522) , (0.749 ±0.353) , (0.706 ±0. 360)mmVkPa,There were statistical difference among the groups(F = 4.512,/><0.01). Compared group A,B with group C,there were statistical differences (t= 2.685,2. 284, all P < 0. 05 ) , Compared group A, B with group D, there were statistical differences (t=2. 881,2.509,all P <0.05) ;α in group A,B,C and D were(4. 287 ± 1.620) ,(4. 870 ± 1.969) ,(6.714 ±3. 891) , (7. 283 ± 4. 102 ) , There were statistical difference among the groups ( F = 4. 103, P < 0. 01 ). Compared group A, B with group C, there were statistical differences (t =2. 183,2. 222, all P < 0. 05 ). Compared group A, B with group D, there were statistical differences (t= 2. 607 、2.745, all P < 0. 05 ) ; β in group A,B,C and D were (8. 662 ±3. 259),(9.927 ±3. 969) ,( 13. 599 ±7. 781),( 14. 777 ±8.235), There were statistical difference among the groups (F = 4. 162,P<0.01). Compared group A,B with group C,there were statistical differences (t= 2.215,2. 206,all P <0. 05). Compared group A,B with group D, there were statistical differences (t= 2. 656,2. 753, all P < 0. 05). Conclusions There was certain correlation between the value of carotid artery elastic parameters and the severity of the coronary artery lesions. The evaluation of carotid artery elasticity measured by ultrasound radio frequency data technique could be considered as one of the non -invasive diagnostic methods in evaluating coronary artery disease.%目的 探讨射频超声血管测量技术在评价冠心病患者颈动脉弹性及其与冠状动脉病变关系中的应用价值.方法 选择临床疑似冠心病患者127例为研究对象,根据冠状动脉造影结果分为非冠心病组(A组:对照组)、冠状动脉粥样硬化病变组(B组)、单支病变组(C组)、多支病变组(D组).对以上4组患者行颈总动脉射频超声检查,记录颈动脉弹性参数,包括血管内中膜厚度(IMT)、脉搏波传导速度(PWV)、动脉管壁的扩张性系数(DC)和顺应性系数(CC)、硬度指数(α)、硬度指数(β),运用统计学方法比较4组间各参数的差异并对其进行相关性分析.结果 A、B、C及D组IMT分别为(586.250±124.12)、(586.567±128.21)、(626.432±124.51)、(691.033±132.01)μm,组间差异有统计学意义(F=3.923,P＜0.05),且A、B、C组分别与D组比较,差异有统计学意义(t=2.404、3.171、2.061,P均＜0.05);A、B、C及D组PWV分别为(7.561±1.411)、(7.742±1.715)、(9.014±2.339)、(9.420±2.624)m/s,组间差异有统计学意义(F=4.175,P＜0.01),且A、B组分别与C组比较,差异有统计学意义(t=1.996、2.343,P均<0.05),且A、B组分别与D组比较(t=2.471、2.917,P均<0.05);A、B、C及D组DC分别为(0.021±0.010)、(0.018±0.009)、(0.015±0.007)、(0.013±0.007)l/kPa,组间差异有统计学意义(F=3.740,P＜0.05),且A组与C组比较(t=3.089,P＜0.05),且A、B组分别与D组比较(t=2.761、2.416,P均＜0.05);A、B、C及D组CC分别为(1.141±0.620)、(0.997±0.522)、(0.749±0.353)、(0.706±0.360)mm2/kPa,组间差异有统计学意义(F=4.512,P＜0.01),且A、B组分别与C组比较,差异有统计学意义(t=2.685、2.284,P均＜0.05),且A、B组分别与D组比较(t=2.881、2.509,P均＜0.05);A、B、C及D组α 分别为(4.287±1.620)、(4.870±1.969)、(6.714±3.891)、(7.283±4.102),组间差异有统计学意义(F=4.103,P＜0.01),且A、B组分别与C组比较,差异有统计学意义(t=2.183、2.222,P均＜0.05),且A、B组分别与D组比较,差异有统计学意义(t=2.607、2.745,P均＜0.05);A、B、C及D组β分别为(8.662±3.259)、(9.927±3.969)、(13.599±7.781)、(14.777±8.235),组间差异有统计学意义(F=4.162,P＜0.01),且A、B组分别与C组比较,差异有统计学意义(t=2.215、2.206,P均＜0.05),且A、B组分别与D组比较,差异有统计学意义(t=2.656、2.753,P均＜0.05).结论 颈动脉弹性参数与冠状动脉病变程度呈一定相关性,射频超声血管测量技术评价颈动脉弹性有可能作为间接反映冠状动脉病变程度的超声无创诊断手段之一.