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美国黑人青年长期应用可卡因对颈内动脉管径的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第1期
页码:
36-44
栏目:
基础研究
出版日期:
2007-01-01

文章信息/Info

Title:
Effects of long term cocaine use on the caliber of internal carotid artery in an AfricanAmerican population
作者:
杜捷夫1; 3 ;  TONG Wenjing 2;  LAI Hong3;  LAI Shenghan2
1.解放军总医院急诊科，北京 100853； 2. Departments of Pathology， 3. Departments of Ophthalmology， Johns Hopkins Medical Institutions, Baltimore, MD 21205
Author(s):
DU Jiefu1; 3;  TONG Wenjing 2;  LAI Hong3;  LAI Shenghan2
1.Department of Emergency, Chinese PLA General Hospital, Beijing 100853,China; 2.Departments of Pathology, 3.Department of Ophthalmology. Johns Hopkins Medical Institutions, Baltimore, MD 21205 USA.
关键词:
可卡因; 颈内动脉; 核磁共振
Keywords:
cocaine internal carotid vessel MRI
分类号:
R996
DOI:
-
文献标识码:
A
摘要:
目的 观察美国黑人青年长期应用可卡因对其颈内动脉管径变化的影响。方法 对美国巴尔地摩市57名可能有应用可卡因历史的黑人青年进行问卷调查，同时抽血检测血常规、血脂、C反应蛋白（CRP），并行颈内动脉核磁共振检查（MRI）以了解颈内动脉结构的变化情况。应用多元回归模型分析颈内动脉管径变化与应用可卡因的关系。结果 在应用可卡因的患者（n=40）CRP及白细胞总数WBC（1×109/L）较未应用过可卡因的患者（n=17）均略有升高［(5.14±12.31) vs (1.29±0.92)μg/L, P=0.059及(5.03±1.70) vs (4.12±1.22), P=0.059］，而平均红细胞容积（MCH）和平均红血球浓度（MCHC）稍低于未用过可卡因的患者［(29.34±2.18) vs (31.77±4.50)pg,P=0.055及(33.23±0.75) vs (33.67±0.49)g/dl, P=0.38，但均无显著差别。平均颈内动脉壁厚度（MTICV）可卡因组与无可卡因组未见显著差别［(0.952±0.244) vs (0.968±0.275)cm, P=0.822］，颈内动脉壁增厚者（MTICV>1.0 cm）比例两组无显著差别（25.0% vs 29.4%, P=0.729）；应用单变量线性回归模型分析，可见颈内动脉水平测量外径（HOD）、垂直内径（VID）、外轮廓面积（OA）、颈内动脉内轮廓面积（ILA）、外轮廓体积（OV）、内径轮廓体积（LV）与应用可卡因呈显著负相关。应用多变量回归模型分析，可见颈内动脉的HOD,VID,OA,ILA,OV,LV仅与应用可卡因呈现显著负相关，而颈内动脉的管径变化与年龄、性别、身高体质量指数（BMI）、CRP、HIV感染无相关性。结论 长期慢性应用可卡因可造成颈内动脉的缩窄。由于动脉长期缩窄可引起动脉缺血和动脉粥样硬化，由此或可推论长期慢性应用可卡因引起的颈内动脉收缩也许是动脉粥样硬化最初表现的形式。
Abstract:
AIM To investigate the effect of long term using cocaine on internal carotid artery among the AfricanAmerican young adults in Baltimore, Maryland. METHODS 57 participants had been interviewed for sociodemographics, druguse behaviors, had had tests of lipid profiles and highsensitivity Creactive protein and MRI was performed to detect the internal carotid artery vessel, then, multivariates linear regression model was used to analyze the correlations of long term cocaine exposure with the carotid artery vessel change. RESULTS Of the 57 study participants, the cocaine user group(n=40) had no significantly but a slightly elevated levels of CRP［(5.14±12.31) vs (1.29±0.92)μg/L,P=0.059］, WBC［(5.03±1.70) vs (4.12±1.22)×109/L, P=0.059］, no significantly but a slightly lower levels of MCH［(29.34±2.18) vs (31.77±4.50)pg,P=0.055］, MCHC［(33.23±0.75) vs (33.67±0.49)g/dl, P=0.38］ with noncocaine user group(n=17). There was neither significant difference of the mean thickness of internal carotid vessel(MTICV) between the cocaine users group (0.952±0.244)cm with noncocaine users group ［(0.968±0.275)cm, P=0.822］, nor significant difference of the percent of MTICV>1.0 cm as the wall being thicken between the two groups (25% of cocaine users vs 29.4% of non cocaine users, P=0.729). Using univariate liner regression model, we found that the horizontal outer contour diameter(HOD), vertical inner lumen diameter(VID), outer area of contour(OA), inner lumen area (ILA), outer volume(OV) and lumen volume(LV) of the internal carotid artery vessel contour had significant negative correlation with cocaine use. The horizontal inner lumen diameter(HID), vertical outer contour diameter(VOD), vertical thickness of vessel wall(VTW), horizontal thickness of the vessel wall(HTW), the thickest vessel wall(TVW) and MTICV had no significant relationship with cocaine using. Multiplevariates linear regression model showed only the cocaine use had significant negative correlation with the HOD, VID, OA, ILA, OV and LV of the internal carotid artery vessel contour while HIV infection, age, gender, BMI and CRP had no significant correlation with the internal carotid artery vessels changes. CONCLUSIONS longterm cocaine using had the effect of contraction on the internal carotid artery vessel. Because the contraction may initiate a cascade of brain tissue ischemia and brain vessel atherosclerosis, we may get the hypothesis that long term use of cocaine may have the effect of vasoconstriction as an early stage of atherosclerosis on the artery system of human beings.

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备注/Memo

备注/Memo:
收稿日期：2006-08-30.基金项目: 美国国立卫生研究院（NIH）RO1DA12777，RO1DA04334， RO1DA12568资金项目资助 通讯作者：Shenghan Lai, MD, MPH. 作者简介：杜捷夫，副主任医师
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