| 摘要: |
| 目的 探讨颈动脉斑块人群的血管壁剪应力(wall shear stress ,WSS)的分布特点及与心脑血管疾病发生的相关性。 方法 入选2018年9月~12月期间在我科行颈部血管超声检查存在斑块且血生化检查及病史资料完整者228例,按照有无冠心病(CHD)或脑梗分为两组：无冠心病和脑梗组,记为无病组；有冠心病或脑梗组,记为患病组。比较血管斑块处与其近端、远端的血管壁剪应力有无统计学差异。93例患病组(实验组)和135例无病组(对照组)行对比试验,分别行单因素和多因素分析研究血管壁剪应力对于心脑血管疾病发生的独立影响。 结果 双侧颈动脉分叉处斑块处的WSS明显低于其近端及远端的WSS,有显著统计学差异(P＜0.05)；TC(OR=0.19,95%CL 为0.04~0.81,P＜0.05)、脉压差(OR=1.10,95%CL 为1.03~1.18,P＜0.05)和 LCCABIF前壁WSS值(OR=5.855,95%CL 为1.007~34.053,P＜0.05)为心脑血管疾病发生的独立危险因素。结论 血管壁剪应力的改变与颈动脉斑块的形成密切相关；LCCABIF前壁WSSa值或许可以作为前瞻性“指标物”,对颈动脉斑块患者的心脑血管疾病发病风险进行早期预判,从而减少心脑血管恶性事件的发生,降低其致死率。 |
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| Analyzing the correlation between vascular wall shear stress and cardiovascular and cerebrovascular diseases in patients with carotid artery plaque by blood flow vector imaging |
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| Abstract: |
| Objective To investigate the distribution characteristics of wall shear stress (WSS) in carotid plaque patients and its correlation with cardiovascular and cerebrovascular diseases. Methods 228 patients who underwent neck vascular ultrasound examination with plaque and had complete blood biochemical examination and medical history in our department from September to December in 2018 were selected and divided into two groups according to the presence or absence of coronary heart disease (CHD) or cerebral infarction: No coronary heart disease and cerebral infarction group was recorded as no disease group; The group with coronary heart disease or cerebral infarction was recorded as the sick group. There was no statistical difference in the vascular wall shear stress between the plaque and its proximal and distal ends. 93 patients in the diseased group (experimental group) and 135 patients in the disease-free group (control group) were compared by single factor analysis and multi-factor analysis respectively to study the independent influence of vascular wall Shear stress on the occurrence of cardiovascular and cerebrovascular diseases. Results WSS at bifurcation plaques of bilateral carotid arteries was significantly lower than that at the proximal and distal ends, with statistically significant difference (P < 0.05). Multivariate Logistic regression analysis suggested that TC(OR=0.19, 95%CL=0.04~0.81, P＜0.05)、pulseSpressure(OR=1.10, 95%CL =1.03~1.18, P＜0.05) and WSS value(OR=5.855, 95%CL = 1.007~34.053, P < 0.05) at the anterior wall plaque at the bifurcation of the left carotid artery was an independent factor affecting the occurrence of cardiovascular and cerebrovascular diseases. Conclusion The change of vascular wall shear stress is closely related to the formation of carotid plaque; for patients with atherosclerosis, the increase of the shear stress of the anterior wall of the bifurcation of the left carotid artery can be used as a sentinel indicator to predict cardiovascular and cerebrovascular diseases, so as to prevent and delay the further occurrence of cardiovascular and cerebrovascular events as early as possible. |
| Key words: Blood flow vector imaging Shear stress of vascular wall Neck vascular plaque |