安田 英明¹, 坪井 英之², 曽根 孝仁²

Hideaki YASUDA¹, Hideyuki TSUBOI², Takahito SONE²

¹大垣市民病院医療技術部診療検査科形態診断室, ²大垣市民病院循環器科

¹Department of Clinical Reserch, Ogaki Municipal Hospital, ²Department of Cardiology, Ogaki Municipal Hospital

キーワード : carotid US, IMT, plaque score, risk factor

目的：頸動脈硬化に影響をおよぼす危険因子を検討する. 対象および方法：頸動脈超音波検査を施行した678 例を対象とし, 総頸動脈の内中膜複合体厚(以下IMT) および, 頸動脈全体のプラークの高さの総和(プラークスコア：PS) が, 性,年齢, 喫煙, 糖尿病, 高脂血症, 高血圧, 肥満とどのような関係があるのか検討した. 結果：1) IMT に関与する因子は,男性では年齢(p＜0.0001), 糖尿病(p＝0.0015), 喫煙(p＝0.0027) であった. 女性では年齢(p＜0.0001), 高血圧(p＝0.0247) であった. PS に関与する因子は, 男性では年齢(p＜0.0001), 喫煙(p＜0.0001), 糖尿病(p＝0.0038),高脂血症(p＝0.0064), 高血圧(p＝0.0069) であった. 女性では年齢(p＜0.0001), 高脂血症(p＝0.0123) であった.2) 保有因子数による影響は, 男性においてIMT では, 因子数が5 個になると有意(p＜0.005) に肥厚した. PS は, 因子数が3 個以上になると有意(p＜0.05) に増大した. 女性はIMT, PS 共に危険因子数による差は認めなかった. 結語：頸動脈硬化に強く関与する因子は加齢, 糖尿病, 喫煙であった. また, 女性より男性の方が, 影響を受けやすかった.

Purpose: To evaluate risk factors affecting carotid atherosclerosis. Subjects and Methods: Six hundred seventy-eight subjects, who underwent carotid ultrasonographic examination participated in this study of the relation between risk factors of atherosclerosis and influence on intima-media thickness (IMT) of the common carotid artery and plaque score (PS) in the carotid artery. Elevated values were found in results of linear regression analysis by sex when IMT and PS were used as induced variables, and age, history of smoking, diabetes mellitus, hyperlipidemia, hypertension, and obesity served as independent variables. Results: Factors related to IMT thickening in the common carotid arteries of the men were age (p＜0.0001), diabetes mellitus (p＝0.0015), and smoking (p＝0.0027); for women, age (p＜0.0001) and hypertension (p＝0.0247). Factors related to PS in men were age (p＜0.0001), smoking (p＜0.0001), diabetes mellitus (p＝0.0038), hyperlipidemia (p＝0.0064), and hypertension (p＝0.0069); in women, age (p＜0.0001) and hyperlipidemia (p＝0.0123). The relation between number of risk factors possessed by men and IMT was not significant in groups 0 (number of risk factors) through 4; however, group 5 showed significant thickening (p＜0.005). PS increased significantly when the number of factors exceeded 3 (p＜0.05). Neither IMT nor PS in varied significantly with number of risk factors possessed. Conclusions: First, age, diabetes mellitus, and history of smoking were strongly associated with carotid atherosclerosis.. Second, men were more likely to be influenced by these factors than women.