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|本期目录/Table of Contents|

慢性丙型肝炎与颈总动脉弹性的相关性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第6期
页码:
688-691,700
栏目:
临床研究
出版日期:
2017-06-01

文章信息/Info

Title:
Correlations between chronic hepatitis C and common carotid artery elasticity
作者:
朱 宁; 闵斌英; 贺春翔; 杨瑞静; 段云友; 杨一林
（第四军医大学唐都医院超声诊断科，陕西 西安 710038）
Author(s):
ZHU Ning;  MIN Bin-ying;  HE Chun-xiang;  YANG Rui-jing;  DUAN Yun-you;  YANG Yi-lin
(Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi’an 710038, Shaanxi, China)
关键词:
射频超声; 慢性丙型肝炎; 动脉硬度; 颈总动脉
Keywords:
radio frequency ultrasonography;  chronic hepatitis C;  arterial stiffness;  common carotid artery
分类号:
R512.63
DOI:
-
文献标识码:
A
摘要:
目的 采用射频超声血管定量技术检测慢性丙型肝炎（chronic hepatitis c,CHC）患者的颈总动脉弹性，分析CHC与颈总动脉弹性的相关性。 方法 选取70例CHC患者(慢性肝炎组）和64例年龄性别匹配、无肝病病史的健康人（正常对照组），对以上两组研究对象分别进行肝脏声辐射力脉冲（acoustic radiation force impulse,ARFI）成像检查和颈总动脉射频超声检查，记录一般项目、生化指标、颈总动脉弹性参数和肝脏硬度参数，颈动脉弹性参数包括血管内中膜厚度（intima-media thickness,IMT），脉搏波传导速度（pulse wave velocity,PWV），动脉管壁扩张性系数（distention coefficient,DC）和顺应性系数（compliance coefficient,CC），硬度指数α、β，动脉增强指数（augmentation index,AIx）。比较正常对照组和CHC组患者组各项参数，比较CHC患者左右侧颈总动脉弹性差异，比较不同糖耐量水平CHC患者颈动脉弹性的差异。 结果 ①CHC患者组的体质量指数（BMI）、空腹血糖(FPG)、糖化血红蛋白、天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、白蛋白、血小板等临床指标均显著高于正常对照组（均P<0.05）。②CHC患者ARFI值显著高于对照组〔(1.86±0.37)m/s vs.(1.04±0.11)m/s〕。 CHC组颈总动脉的PWV〔(8.0±1.4)m/s vs.(6.1±0.9)m/s〕、DC〔(0.017±0.008)1/kPa vs.(0.032±0.008)1/kPa〕、CC〔(0.82±0.38)mm2/kPa vs.(1.29±0.25)mm2/kPa〕、α(5.8±2.3 vs. 3.0±0.8)、β(11.7±4.5 vs. 6.2±1.6)等弹性参数与正常对照组差异显著（均P<0.01）。③CHC患者FPG升高组的IMT高于空腹血糖正常组（P<0.01）；前者PWV、α、β高于后者，DC、CC低于后者。④CHC患者的FPG与IMT、PWV、α、β正相关（P<0.05），与DC、CC负相关（P<0.05）。结论 CHC患者不仅肝脏硬度明显增加，而且颈动脉弹性参数也发生变化。利用ARFI技术和射频超声无创检测CHC患者的肝脏硬度和颈动脉弹性参数，对CHC患者心血管事件的监测有一定帮助。
Abstract:
AIM To explore changes in common carotid artery elasticity of CHC (chronic Hepatitis C) patients using radio frequency ultrasonography for evaluation of artery function. METHODS 70 patients with Hepatitis C virus infection and 64 age and sex matched healthy volunteers underwent ARFI (Acoustic Radiation Force Impulse) imaging and radio frequency ultrasonography. Parameters of liver stiffness and artery elasticity recorded were as follows: ARFI velocity, intima-media thickness (IMT), pulse wave velocity (PWV), distention coefficient (DC), compliance coefficient (CC), stiffness parameter α and β, augmentation index (AIx). Demographic characteristics and biochemical markers were also recorded. Data were compared between two groups of study subjects, two sides of carotid arteries, and CHC patients with different levels of fasting blood glucose. RESULTS CHC Patients had significantly higher ARFI and less favorable elasticity parameters than the control group. After adjusting for demographics and biomarkers, CHC patients still had higher PWV, α, β and lower DC, CC values than the control group (P<0.01). CHC patients with higher blood glucose levels (>6.11 mmol/L) had less favorable artery elasticity than those with normal values. Blood glucose levels was positively correlated with IMT, PWV, α, β while negatively with DC, CC in CHC patients. CONCLUSION CHC patients have higher ARFI values and less favorable artery elasticity than uninfected control, indicating that monitoring artery elasticity using radio frequency ultrasonography may be clinically useful for CHC patients.

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备注/Memo

备注/Memo:
收稿日期：2017-03-28.基金项目：国家自然科学基金项目资助（81371566）
通讯作者：杨一林，副教授，主要从事腹部及浅表器官超声诊断研究 Email：yangyl66@126.com
作者简介：朱宁，博士生 Email：zhuning10@outlook.com
更新日期/Last Update: 2017-06-06