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李洁,王静,谢明星,吕清,游曼洁.二维斑点追踪成像评价代谢综合征患者颈动脉弹性[J].中国医学影像技术,2016,32(2):248~253

二维斑点追踪成像评价代谢综合征患者颈动脉弹性

Two-dimensional speckle tracking imaging on evaluation of carotid artery stiffness in patients with metabolic syndrome

投稿时间：2015-07-31 修订日期：2015-08-10

DOI：10.13929/j.1003-3289.2016.02.022

中文关键词: 代谢综合征颈动脉僵硬度斑点追踪

英文关键词:Metabolic syndrome Carotid artery Stiffness speckle Tracking

基金项目:

作者	单位	E-mail
李洁	华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像重点实验室, 湖北武汉 430022 宜昌市中心人民医院超声科三峡大学第一临床医学院, 湖北宜昌 443003
王静	华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像重点实验室, 湖北武汉 430022	13397105628@163.com
谢明星	华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像重点实验室, 湖北武汉 430022
吕清	华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像重点实验室, 湖北武汉 430022
游曼洁	华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像重点实验室, 湖北武汉 430022

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中文摘要:

目的探讨二维斑点追踪成像技术评价代谢综合征(MS)患者颈动脉弹性的可行性与准确性。方法病例组:收集85例MS患者(病例组),分为3个亚组:高血压合并糖尿病亚组(HDMS组,n=27)、高血压无糖尿病亚组(HMS组,n=29)、糖尿病无高血压亚组(DMS,n=29);正常组:年龄、性别与病例组相匹配的健康志愿者24名。采用2D-STI测量左侧颈总动脉(LCCA)管壁圆周方向上整体及节段收缩期峰值圆周应变(CAS),采用E-Tracking技术测量颈动脉僵硬度系数(β),顺应性(AC)等参数。常规测量左心室结构、功能相关参数。结果 ①与正常组比较,病例组中各亚组患者左心室舒张末内径(LVEDD)、室间隔厚度(IVSD)、左心室后壁厚度(LVPWD)、左心室质量指数(LVMI)及相对室壁厚度(RWT)均增高(P均<0.05),E峰及E/A比值减低(P均<0.05);②MS患者LCCA的β值较正常组增高,AC减低(P<0.05);③病例组中各亚组整体CAS及5~7点、7~9点方向的CAS较正常组均明显降低(P均<0.05);整体CAS与β值(r=-0.469,P<0.01)、年龄(r=-0.413,P<0.01)呈显著负相关,与AC呈正相关(r=0.419,P<0.01);④重复性测量显示CAS观察者内及观察者间的变异系数分别为5.07%、5.40%。结论 MS患者早期出现颈动脉僵硬度增高,收缩期圆周应变减低,以动脉远侧壁为甚,且随病程进展,应变进一步减低。

英文摘要:

Objective To explore the feasibility and accuracy of two-dimensional speckle tracking (2D-STI) in assessing the carotid artery elasticity in patients with metabolic syndrome (MS).Methods Eighty-five patients with MS (MS group) were divided into three sub-groups,i.e.MS with hypertension and diabetes sub-group (HDMS,n=27),MS with hypertension sub-group (HMS,n=29) and MS with diabetes sub-group (DMS,n=29),and then the age and sex matched healthy volunteers were enrolled in control group (n=24).The global and segmental systolic peak circumferential strain (CAS) of the left common carotid (LCCA) was measured by 2D-STI.E-Tracking (ET) was performed to follow the movement of the wall and stiffness parameter (β),arterial compliance (AC) were assessed.Routine echocardiography was used to measure the parameters of left ventricular structure and function.Results ①left ventricular end-diastolic diameter (LVEDD),interventricular septum thickness (LVSD),left ventricular posterior wall thickness (LVPWD),left ventricular mass index (LVMI) and relative wall thickness (RWT) increased in MS patients compared with those in control group(all P<0.05),E peak and E/A was lower significantly (all P<0.05).②Compared to control group,β increased while AC decreased in patients with MS (all P<0.05).③In three sub-groups,the global CAS,the segments of 5-7,7-9 CAS were lower significantly compared with those in control group (all P<0.05).Global CAS was significantly inversely correlated with stiffness parameter β (r=-0.469,P<0.01) and age (r=-0.413,P<0.01),positively correlated with AC (r=0.419,P<0.01).④The Bland-Altman map showed that the coefficient of variation of inter-observer and intra-observer of CAS were 5.07%,5.40%.Conclusion In patients with MS,the stiffness of carotid artery abnormally increase,and circumferential strain decrease,especially in distal wall of artery.CAS will further reduce with the progression of MS.

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