应用E-Tracking技术检测睡眠呼吸暂停综合征患者颈动脉弹性
发布时间：2018-12-31 21:47
【摘要】：睡眠呼吸暂停综合征是指在夜间睡眠情况下出现的，由于气道受阻或其他原因引起的呼吸暂停和/或低通气，导致机体处于低氧合并高碳酸血症的状态，从而产生多种病理生理改变和临床表现的一组综合征。是临床上常见的一种疾病，严重威胁人类的健康。睡眠呼吸暂停综合征与动脉粥样硬化发生可能存在相关性。本研究以单纯睡眠呼吸暂停综合征患者及伴有高血压睡眠呼吸暂停综合征组患者为研究对象，应用二维超声方法检测颈动脉内中膜厚度，应用血管回声跟踪技术检测颈动脉弹性参数，以探讨睡眠呼吸暂停综合征与动脉弹性变化之间的关系，为进一步研究睡眠呼吸暂停综合征的病理生理和临床上对睡眠呼吸暂停综合征的治疗提供资料。 研究对象分为A组（正常对照组）：健康成年人36例，其中男性22例，女性14例，平均年龄为46±8.87岁；B组（单纯睡眠呼吸暂停综合征组）：诊断为睡眠呼吸暂停综合征的患者36例，其中男性26例，女性10例，平均年龄为45.67±12.01岁；C组（睡眠呼吸暂停综合征合并高血压组）：诊断为睡眠呼吸暂停综合征同时伴有高血压的患者30例，其中男性21例，女性9例，平均年龄为49.13±17.81岁。对研究对象进行各项目检测。检测项目及方法包括：血压；应用二维超声观察颈总动脉及颈内、外动脉有无斑块形成，测量颈总动脉内中膜厚度（IMT）；应用超声ET技术检测左右侧颈总动脉的弹性参数，包括动脉僵硬度指数（β）、血管压力-应变弹性系数（Eρ）、血管顺应性（AC）、脉搏波传导速度（PWVβ）。 检测结果：1.左右侧颈总动脉IMT值：C组＞B组＞A组，各组间比较有显著性差异；2.左右侧颈总动脉的β和Eρ值：C组＞B组＞A组，各组间比较有显著性差异；3.左右侧颈总动脉的AC值：C组＜B组＜A组，各组间比较有显著性差异；4.左右侧颈总动脉的PWVβ值：C组、B组＞A组，A组与B组比较、A组与C组间比较，均有显著性差异； B组与C组比较，无显著性差异；5.根据颈动脉IMT和斑块发生情况将B、C组研究对象各分为三组，B0、C0组：IMT＜0.09mm，无斑块； B1、C1组：IMT0.09mm，无斑块；B2、C2组：有斑块。在B组中，左右侧颈总动脉β值：B2组＞B0、B1组，，B2组与B0、B1组比较，均具有显著性差异；在C组中，β、Eρ值：C1组、C2组＞C0组，C1组、C2组分别与C0组比较，差异均具有显著性，AC值：C2组＜C0组，C2与C0组比较，差异具有显著性，PWVβ值：C2组＞C0组，C2组与C0组比较，差异均具有显著性。 本文研究结果显示：睡眠暂停综合征是导致动脉粥样硬化发生的一个危险因素，首先可以导致动脉功能改变，使弹性减退；进一步还可以引起动脉血管形态学改变，包括动脉IMT增厚和动脉粥样斑块形成。睡眠呼吸暂停综合征患者由于反复的低氧-复氧导致血管内皮细胞受损，内皮细胞功能失调，代谢改变，同时血脂代谢异常、血液粘稠度的增加等病理生理改变，这些都促进了动脉粥样硬化的发生，使动脉弹性减低、动脉粥样斑块形成。睡眠暂停综合征合并高血压时可以使动脉功能和形态改变加重，促进动脉粥样硬化的发生。 本项研究应用E-Tracking技术对睡眠暂停综合征患者的动脉僵硬度β、弹性系数Eρ、脉搏波传导速度PWVβ及顺应性AC值等血管弹性指标进行检测，目前这方面的研究资料很少。E-Tracking技术能够自动跟踪动脉血管壁收缩期及舒张期的管径变化，自动计算各弹性系数数值，使计算结果更加准确。E-Tracking作为一种无创的检查方式，能够早期、准确的评价睡眠呼吸暂停综合征患者外周动脉弹性，为睡眠呼吸暂停综合征患者动脉弹性改变的早期诊断和治疗提供信息。
[Abstract]:A sleep apnea syndrome refers to a state in which the body is in a low-oxygen combined hypercapnia due to the apnea and/ or low ventilation that occur at night, due to the obstruction of the airway or other causes, resulting in a set of syndromes of various pathophysiological changes and clinical manifestations. is a clinically common disease that is a serious threat to human health. Sleep apnea syndrome may be associated with the occurrence of atherosclerosis. in this study, a two-dimensional ultrasound method was used to detect the thickness of the membrane in the carotid artery and the elastic parameters of the carotid artery were detected by the method of two-dimensional ultrasound. In order to study the relationship between sleep apnea syndrome and the change of arterial elasticity, it is necessary to provide data for the further study of the pathophysiology of sleep apnea syndrome and the treatment of sleep apnea syndrome. The subjects were divided into group A (normal control group): 36 healthy adults, 22 of which were male and 14 female, with an average age of 46 to 8.87; group B (group of simple sleep apnea syndrome): 36 patients diagnosed as sleep apnea syndrome, of which 26 were male In 10 patients, the average age was 45. 67 and 12. 01; group C (sleep apnea syndrome combined with hypertension group): 30 patients with sleep apnea syndrome accompanied by hypertension: 21 males and 9 females with an average age of 49. 13 and 17. 81 years of age. The study subjects are subject to each item inspection. The test items and methods include: blood pressure; using two-dimensional ultrasound to observe the presence or absence of plaque in the common carotid artery and the internal carotid and external arteries, and measuring the membrane thickness (IMT) in the common carotid artery; and using the ultrasonic ET technique to detect the elastic parameters of the common carotid artery at the left and right sides, including the arterial stiffness index (.), vessel pressure-strain elastic coefficient (E), vascular compliance (AC), pulse wave conduction velocity (PWV)). Detection of the junction Results: 1. The IMT value of the common carotid artery in left and right neck: group C> group B> group A, and there was a significant difference among the groups. In group C, group B> group A, there was a significant difference between the groups. The AC value of total artery in left and right neck of left and right neck: group C was less than that in group B, and there was a significant difference among the groups. In group A and group B, there was significant difference between group A and group C, and there was no significant difference between group A and group C. 5. According to the IMT of the carotid artery and the occurrence of plaque, the subjects of group B and C were divided into three groups, B0 and C0 group: IMT <0.09mm, no plaque; B1, group C1: IMT0. 09mm, no plaque; and group B2, group C2: In group B, the total value of total arterial pressure in left and right neck: group B2> B0, B1 group, B2 group and B0 and B1 group had significant difference; in group C, the difference was significant in group C, group C, C1 group, C2 group and C0 group, respectively. AC value: C2 group was less than that of C0 group, and the difference was significant. The value of PWV was: C2 group> C0 group, C2 group and C0 group, the difference was all The results of this study show that the sleep apnea syndrome is a risk factor leading to the occurrence of atherosclerosis, which can lead to a change of the function of the artery and decrease the elasticity of the artery, and further can cause the morphological changes of the arterial vessels, including the arterial IMT thickening and the arterial congee. As a result of repeated hypoxia-reoxygenation in patients with sleep apnea syndrome, vascular endothelial cells are damaged, endothelial cell dysfunction, metabolic changes, abnormal blood lipid metabolism, increased blood viscosity, and the like, all of which promote atherosclerosis. The occurrence of hardening is to reduce the elasticity of the artery, and the arterial congee The formation of the like plaque. The sleep apnea syndrome combined with high blood pressure can increase the function and the shape of the artery, and promote the atherosclerosis. In this study, the arterial stiffness of the patients with sleep apnea syndrome, the elastic coefficient E, the pulse wave conduction velocity (PWV), and the compliance AC value were measured by E-Tracking in this study. The data of the study is very small. The E-Tracking technique can automatically track the changes of the tube diameter of the arterial wall and the diastolic phase, and automatically calculate the value of the elastic coefficient to make the meter The result is more accurate. E-Tracking, as a non-invasive procedure, can be used to evaluate the elasticity of the peripheral artery of the patients with sleep apnea syndrome in an early and accurate way, and it is an early diagnosis of the elastic change of the artery in the patients with sleep apnea syndrome.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R766
本文编号：2397152
[Abstract]:A sleep apnea syndrome refers to a state in which the body is in a low-oxygen combined hypercapnia due to the apnea and/ or low ventilation that occur at night, due to the obstruction of the airway or other causes, resulting in a set of syndromes of various pathophysiological changes and clinical manifestations. is a clinically common disease that is a serious threat to human health. Sleep apnea syndrome may be associated with the occurrence of atherosclerosis. in this study, a two-dimensional ultrasound method was used to detect the thickness of the membrane in the carotid artery and the elastic parameters of the carotid artery were detected by the method of two-dimensional ultrasound. In order to study the relationship between sleep apnea syndrome and the change of arterial elasticity, it is necessary to provide data for the further study of the pathophysiology of sleep apnea syndrome and the treatment of sleep apnea syndrome. The subjects were divided into group A (normal control group): 36 healthy adults, 22 of which were male and 14 female, with an average age of 46 to 8.87; group B (group of simple sleep apnea syndrome): 36 patients diagnosed as sleep apnea syndrome, of which 26 were male In 10 patients, the average age was 45. 67 and 12. 01; group C (sleep apnea syndrome combined with hypertension group): 30 patients with sleep apnea syndrome accompanied by hypertension: 21 males and 9 females with an average age of 49. 13 and 17. 81 years of age. The study subjects are subject to each item inspection. The test items and methods include: blood pressure; using two-dimensional ultrasound to observe the presence or absence of plaque in the common carotid artery and the internal carotid and external arteries, and measuring the membrane thickness (IMT) in the common carotid artery; and using the ultrasonic ET technique to detect the elastic parameters of the common carotid artery at the left and right sides, including the arterial stiffness index (.), vessel pressure-strain elastic coefficient (E), vascular compliance (AC), pulse wave conduction velocity (PWV)). Detection of the junction Results: 1. The IMT value of the common carotid artery in left and right neck: group C> group B> group A, and there was a significant difference among the groups. In group C, group B> group A, there was a significant difference between the groups. The AC value of total artery in left and right neck of left and right neck: group C was less than that in group B, and there was a significant difference among the groups. In group A and group B, there was significant difference between group A and group C, and there was no significant difference between group A and group C. 5. According to the IMT of the carotid artery and the occurrence of plaque, the subjects of group B and C were divided into three groups, B0 and C0 group: IMT <0.09mm, no plaque; B1, group C1: IMT0. 09mm, no plaque; and group B2, group C2: In group B, the total value of total arterial pressure in left and right neck: group B2> B0, B1 group, B2 group and B0 and B1 group had significant difference; in group C, the difference was significant in group C, group C, C1 group, C2 group and C0 group, respectively. AC value: C2 group was less than that of C0 group, and the difference was significant. The value of PWV was: C2 group> C0 group, C2 group and C0 group, the difference was all The results of this study show that the sleep apnea syndrome is a risk factor leading to the occurrence of atherosclerosis, which can lead to a change of the function of the artery and decrease the elasticity of the artery, and further can cause the morphological changes of the arterial vessels, including the arterial IMT thickening and the arterial congee. As a result of repeated hypoxia-reoxygenation in patients with sleep apnea syndrome, vascular endothelial cells are damaged, endothelial cell dysfunction, metabolic changes, abnormal blood lipid metabolism, increased blood viscosity, and the like, all of which promote atherosclerosis. The occurrence of hardening is to reduce the elasticity of the artery, and the arterial congee The formation of the like plaque. The sleep apnea syndrome combined with high blood pressure can increase the function and the shape of the artery, and promote the atherosclerosis. In this study, the arterial stiffness of the patients with sleep apnea syndrome, the elastic coefficient E, the pulse wave conduction velocity (PWV), and the compliance AC value were measured by E-Tracking in this study. The data of the study is very small. The E-Tracking technique can automatically track the changes of the tube diameter of the arterial wall and the diastolic phase, and automatically calculate the value of the elastic coefficient to make the meter The result is more accurate. E-Tracking, as a non-invasive procedure, can be used to evaluate the elasticity of the peripheral artery of the patients with sleep apnea syndrome in an early and accurate way, and it is an early diagnosis of the elastic change of the artery in the patients with sleep apnea syndrome.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R766
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