应用QIMT及QAS技术评价高血脂患者立普妥治疗前后颈总动脉结构和功能

摘要

目的 应用超声射频信号血管内—中膜分析(QIMT)技术及血管硬度定量分析(QAS)技术评估高血脂患者用立普妥治疗前后颈总动脉内—中膜厚度和动脉管壁弹性变化,探讨其在动脉结构和功能及疗效评价中的临床应用.方法 分别获取高血脂患者应用立普妥治疗前和治疗后6个月的颈总动脉内—中膜厚度(IMT)和颈总动脉血管僵硬度参数:脉搏波速度(PWV)、血管硬度参数(β)、顺应性系数(CC),进行治疗前后对比,并将动脉结构和功能参数与血脂指标进行相关分析.结果 治疗后患者颈总动脉内中膜厚度较治疗前变薄；血管僵硬度参数β和PWV较治疗前明显降低,CC明显增高,差异有统计学意义(P＜0.05).IMT、PWV和β参数与总胆固醇(TCH)呈正相关,相关系数分别为0.788 1、0.835 4和0.903 7(P＜0.01); CC与TCH呈负相关(r=0.895 1,P＜0.01).结论 QIMT及QAS技术能定量检测和评估立普妥治疗高血脂患者的颈总动脉内—中膜厚度和动脉管壁弹性,可为临床评价动脉结构和功能及立普妥治疗高血脂疗效判定提供一种定量方法.%Objective To estimate the intima-media thickness and the wall resilience of common carotid arteries (CCA)before and after Lipitor therapy in hyperlipidemia patients using QIMT and QAS. Methods To acquire the intima-media thickness and the wall resilience parameters of CCA, Using QIMT and QAS, including pulse wave velocity (PWV) , stiffness parameter (β) and compliance coefficient (CC) before and after Lipitor therapy for 6 months in the hyperlipidemia patients, the correlation of artery function parameters and TCH was analysed. Results The intimamedia thickness of CCA after Lipitor therapy is lower than that before therapy. The values of PWV and β decreased and CC increased after therapy (P<0. 05). Parameters of IMT, PWV, β are positively correlated with TCH (r = 0.8037, 0.8393 and 0.9581 respectively, P<0.01). The value of CC is negatively correlated with TCH (r = - 0. 9479, P<0. 01). Conclusions QIMT and QAS can quantify accurately intima-media thickness and the wall resilience of CCA in hyperlipidemia patients before and after Lipitor therapy. They can provide availably methods for clinical evaluation on Arteries structure and function to direct clinical treatment.