血管回声跟踪技术在评价绝经期女性颈动脉弹性中的应用

目的应用血管回声跟踪技术评价性激素治疗(HT)后血管弹性的变化情况。方法自然绝经1年以上,年龄50～60岁,诊断为更年期综合征者60例,根据是否进行HT分为:激素组30例,坚持HT 1年以上。对照组30例,未进行激素治疗,进行一般对症治疗。应用E-Tracking技术检测颈总动脉的弹性参数,包括弹性模量(Eρ)、僵硬度(β)、动脉顺应性(AC)、单点脉搏波速度(PWVβ)和膨大指数(AI),并将雌二醇(E2)、内皮依赖性舒张功能(EDD)和内膜中层厚度(IMT)与这些弹性参数进行相关分析。结果激素组β、Eρ、PWVβ明显降低,AC升高(P<0.01)。E2与β、Eρ、PWVβ呈负相关(r分别为-0.607、-0.573、-0.574、P均<0.01);而与AC呈正相关(r=0.574,P<0.01)。EDD与β、Eρ、PWVβ呈负相关(r分别为-0.521、-0.411、-0.456,P均<0.01);而与AC呈正相关(r=0.443,P<0.01)。IMT与β、Eρ、PWVβ呈正相关(r分别为0.553、0.444、0.529,P均<0.01);而与AC呈负相关(r=-0.400,P<0.01)。结论绝经期女性随着雌激素水平的下降,动脉僵硬度增加,激素治疗可使动脉弹性得到一定程度的改善。

Evaluating carotid elasticity in postmenopausal women with echo-tracking technology

Objective To assess the change of carotid artery elasticity after hormone therapy(HT) using echo-tracking(E-tracking) technology.Methods We divided 60 women(50-60 years old with more than one-year natural menopause),who had been diagnosed with climacteric syndrome,into two groups: HT group(n=30) who had HT for at least one year and control group(n=30) without receiving HT.E-tracking was used to evaluate the carotid elasticity parameters,including pressure-strain elasticity modulus(Eρ),stiffness parameter(β),arterial compliance(AC),pulse wave conducting velocity(PWVβ) and augmentation index(AI);we analyzed the correlation of estradial(E2),endothelial-dependent dilatation(EDD) and intima-media thickness(IMT) with these elasticity parameters.Results Eρ,β and PWVβ were significantly lower in HT group than in control group(P< 0.01),while AC was obviously higher than that in control group(P<0.01).E2 was negatively correlated with β,Eρ and PWVβ(r=-0.607,r=-0.573,r=-0.574,P<0.01),but positively correlated with AC(r=0.574,P<0.01).EDD was negatively correlated with β,Eρ and PWVβ(r=-0.521,r=-0.411,r=-0.456,P<0.01),but positively correlated with AC(r=0.443,P<0.01).IMT was positively correlated with β,Eρ and PWVβ(r=0.553,r=0.444,r=0.529,P<0.01),but negatively correlated with AC(r=-0.400,P<0.01).Conclusion Arterial stiffness increases and compliance decreases in menopausal women.HT can improve arterial elasticity to some extent.E-tracking technology can detect effectively the early changes in arterial stiffness and it is more sensitive in finding out the changes of carotid artery stiffness in early atherosclerosis than IMT.