應(yīng)用E-Tracking技術(shù)檢測(cè)睡眠呼吸暫停綜合征患者頸動(dòng)脈彈性
發(fā)布時(shí)間：2018-12-31 21:47
【摘要】：睡眠呼吸暫停綜合征是指在夜間睡眠情況下出現(xiàn)的，由于氣道受阻或其他原因引起的呼吸暫停和/或低通氣，導(dǎo)致機(jī)體處于低氧合并高碳酸血癥的狀態(tài)，從而產(chǎn)生多種病理生理改變和臨床表現(xiàn)的一組綜合征。是臨床上常見的一種疾病，嚴(yán)重威脅人類的健康。睡眠呼吸暫停綜合征與動(dòng)脈粥樣硬化發(fā)生可能存在相關(guān)性。本研究以單純睡眠呼吸暫停綜合征患者及伴有高血壓睡眠呼吸暫停綜合征組患者為研究對(duì)象，應(yīng)用二維超聲方法檢測(cè)頸動(dòng)脈內(nèi)中膜厚度，應(yīng)用血管回聲跟蹤技術(shù)檢測(cè)頸動(dòng)脈彈性參數(shù)，以探討睡眠呼吸暫停綜合征與動(dòng)脈彈性變化之間的關(guān)系，為進(jìn)一步研究睡眠呼吸暫停綜合征的病理生理和臨床上對(duì)睡眠呼吸暫停綜合征的治療提供資料。 研究對(duì)象分為A組（正常對(duì)照組）：健康成年人36例，其中男性22例，女性14例，平均年齡為46±8.87歲；B組（單純睡眠呼吸暫停綜合征組）：診斷為睡眠呼吸暫停綜合征的患者36例，其中男性26例，女性10例，平均年齡為45.67±12.01歲；C組（睡眠呼吸暫停綜合征合并高血壓組）：診斷為睡眠呼吸暫停綜合征同時(shí)伴有高血壓的患者30例，其中男性21例，女性9例，平均年齡為49.13±17.81歲。對(duì)研究對(duì)象進(jìn)行各項(xiàng)目檢測(cè)。檢測(cè)項(xiàng)目及方法包括：血壓；應(yīng)用二維超聲觀察頸總動(dòng)脈及頸內(nèi)、外動(dòng)脈有無斑塊形成，測(cè)量頸總動(dòng)脈內(nèi)中膜厚度（IMT）；應(yīng)用超聲ET技術(shù)檢測(cè)左右側(cè)頸總動(dòng)脈的彈性參數(shù)，包括動(dòng)脈僵硬度指數(shù)（β）、血管壓力-應(yīng)變彈性系數(shù)（Eρ）、血管順應(yīng)性（AC）、脈搏波傳導(dǎo)速度（PWVβ）。 檢測(cè)結(jié)果：1.左右側(cè)頸總動(dòng)脈IMT值：C組＞B組＞A組，各組間比較有顯著性差異；2.左右側(cè)頸總動(dòng)脈的β和Eρ值：C組＞B組＞A組，各組間比較有顯著性差異；3.左右側(cè)頸總動(dòng)脈的AC值：C組＜B組＜A組，各組間比較有顯著性差異；4.左右側(cè)頸總動(dòng)脈的PWVβ值：C組、B組＞A組，A組與B組比較、A組與C組間比較，均有顯著性差異； B組與C組比較，無顯著性差異；5.根據(jù)頸動(dòng)脈IMT和斑塊發(fā)生情況將B、C組研究對(duì)象各分為三組，B0、C0組：IMT＜0.09mm，無斑塊； B1、C1組：IMT0.09mm，無斑塊；B2、C2組：有斑塊。在B組中，左右側(cè)頸總動(dòng)脈β值：B2組＞B0、B1組，，B2組與B0、B1組比較，均具有顯著性差異；在C組中，β、Eρ值：C1組、C2組＞C0組，C1組、C2組分別與C0組比較，差異均具有顯著性，AC值：C2組＜C0組，C2與C0組比較，差異具有顯著性，PWVβ值：C2組＞C0組，C2組與C0組比較，差異均具有顯著性。 本文研究結(jié)果顯示：睡眠暫停綜合征是導(dǎo)致動(dòng)脈粥樣硬化發(fā)生的一個(gè)危險(xiǎn)因素，首先可以導(dǎo)致動(dòng)脈功能改變，使彈性減退；進(jìn)一步還可以引起動(dòng)脈血管形態(tài)學(xué)改變，包括動(dòng)脈IMT增厚和動(dòng)脈粥樣斑塊形成。睡眠呼吸暫停綜合征患者由于反復(fù)的低氧-復(fù)氧導(dǎo)致血管內(nèi)皮細(xì)胞受損，內(nèi)皮細(xì)胞功能失調(diào)，代謝改變，同時(shí)血脂代謝異常、血液粘稠度的增加等病理生理改變，這些都促進(jìn)了動(dòng)脈粥樣硬化的發(fā)生，使動(dòng)脈彈性減低、動(dòng)脈粥樣斑塊形成。睡眠暫停綜合征合并高血壓時(shí)可以使動(dòng)脈功能和形態(tài)改變加重，促進(jìn)動(dòng)脈粥樣硬化的發(fā)生。 本項(xiàng)研究應(yīng)用E-Tracking技術(shù)對(duì)睡眠暫停綜合征患者的動(dòng)脈僵硬度β、彈性系數(shù)Eρ、脈搏波傳導(dǎo)速度PWVβ及順應(yīng)性AC值等血管彈性指標(biāo)進(jìn)行檢測(cè)，目前這方面的研究資料很少。E-Tracking技術(shù)能夠自動(dòng)跟蹤動(dòng)脈血管壁收縮期及舒張期的管徑變化，自動(dòng)計(jì)算各彈性系數(shù)數(shù)值，使計(jì)算結(jié)果更加準(zhǔn)確。E-Tracking作為一種無創(chuàng)的檢查方式，能夠早期、準(zhǔn)確的評(píng)價(jià)睡眠呼吸暫停綜合征患者外周動(dòng)脈彈性，為睡眠呼吸暫停綜合征患者動(dòng)脈彈性改變的早期診斷和治療提供信息。
[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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R766
本文編號(hào)：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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R766
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