Study Of Evaluation Methods Of Atherosclerosis And Intervention Of Risk Factors

Atherosclerosis(AS)is the pathological basis of cardiovascular and cerebrovascular diseases,such as coronary heart disease,stroke.AS is a progressive pathological process characterized by intimal hyperplasia,hardening and elasticity reduction of arterial wall,which leads to stenosis of lumen,abnormal vasoconstriction and diastolic function.AS can be divided into arterial elastic dysfunction and arterial structural lesions.Age,hypertension,diabetes,dyslipidemia,inadequate physical activity,unhealthy dietary habits and other risk factors significantly accelerate the development of AS,and age is the primary one.Imaging such as carotid ultrasonography,computed tomography(CT),magnetic resonance imaging is an effective method to detect arterial structural lesions in clinic.However,in practice,there are some defects,such as high cost,complex operation and the need for professional image readers,which limit the wide application of imaging as a screening for arteriosclerosis.With the focus of prevention and treatment of CVD moving forward,the intervention of preclinical atherosclerosis has become a hot topic in medical research.The core content of CVD prevention is to develop appropriate technical means,early detection of abnormal acceleration of atherosclerosis,screen people who have evidence of atherosclerosis but have no obvious clinical symptoms,and delay the process of atherosclerosis through comprehensive intervention of risk factors.Based on the above requirements,this thesis focuses on the diastolic augmentation index(DAI)and brachial-ankle pulse wave velocity(baPWV)obtained by non-invasive testing equipment to evaluate the ability of atherosclerosis,the main determinants of atherosclerosis and lifestyle interventions for these risk factors.The contents of the thesis are as follows:1.Study on evaluation method of arteriosclerosisThe shape of diastolic radial artery waveform was analyzed through pulse wave analysis technology,and the index DAI reflecting the elasticity of artery was put forward.71 subjects were sampled by simple random sampling.The radial augmentation index(AI),corresponding DAI and arotid intima media thickness(CIMT)were mearsured.The results showed that DAI had a higher correlation with CIMT than AI,and was not affected by height,heart rate and other interference factors,so it could better evaluate carotid atherosclerosis.Further,baPWV,an index for evaluating arterial elasticity,was proposed to screen arterial structural lesions.The sensitivity,specificity and AUC of baPWV screening for carotis atherosclerosis were 72.9%,75.6%and 0.789,and the sensitivity,specificity and AUC of screening for thoracic aortic calcification were 78%,69.1%and 0.772.In view of the low cost and easy operation of baPWV,baPWV can be used as a screening index for CA and TAC in grass-roots units with limited medical resources,and different baPWV values for different age groups can effectively improve its ability to screen carotid atherosclerosis.2.Study on the main risk factors of atherosclerosisAS is the result of combined action of hypertension,diabetes and other risk factors.However,due to differences in lifestyle,the distribution of risk factors of atherosclerosis varies from regions and population.This chapter further explores the main risk factors of AS in Hefei population.Multivariate linear regression analysis showed that besides traditional risk factors such as age,hypertension,systolic blood pressure(SBP),subendocardial viability ratio(SEVR)and ejection duration(ED)were also the main risk factors for atherosclerosis in Hefei area.The above five indicators explained 74.8%of baPWV variation.In addition,baPWV is positively correlated with the number of risk factors,and increases exponentially with the increase of the number of risk factors,which suggests that special attention should be paid to the high-risk population with aggregated risk factors in the prevention and control of atherosclerosis.This suggests that in the prevention and treatment of atherosclerosis,in addition to controlling traditional risk factors,we should also focus on improving the cardiac blood supply capacity.3.The effect of lifestyle on risk factors of atherosclerosisUnhealthy lifestyle is the main reason of uncontrolled blood pressure of hypertension population.It is of great significance to study the lifestyle factors of influencing the effect of blood pressure control in Hefei area for preventing hypertension and delaying the process of atherosclerosis.A total of 282 patients with hypertension were randomly sampled.The results showed that:(1)Hypertension control is very important to the progress of atherosclerosis.(2)Saturated fatty acid food intake,high oil diet,smoking and excessive alcohol consumption are the main lifestyle factors affecting blood pressure control in hypertensive population in Hefei.This provides an intervention direction for delaying the process of atherosclerosis and preventing cardiovascular diseases in Hefei.4.Early intervention of atherosclerosis based on lifestyle managementBased on the above-mentioned screening indicators and risk factors analysis of atherosclerosis,a health promotion service system was constructed and applied in Hefei Jianghe Community Health Service Center and Health Promotion Service Center of Science Island.Blood pressure,AI,DAI,SEVR,ED and baPWV were measured by cardiovascular function tester(BX-CFTI-100)and arteriosclerosis detector(BX-AS-100B)developed by the laboratory independently.The lifestyles such as exercise habits,dietary habits and behavioral patterns were obtained by questionnaire.Based on the above indicators,personalized lifestyles were provided through health promotion service system.Follow-up results showed that the exercise habits,dietary habits and behavioral patterns of the residents were significantly improved after the intervention,and the risk factors of atherosclerosis such as blood pressure,SEVR were controlled,and baPWV also showed a downward trend.Therefore,the evaluation method of atherosclerosis studied in this paper can effectively screen the atherosclerosis of grass-roots residents,improve the risk factors of atherosclerosis and delay the process of atherosclerosis through individual intervention of lifestyle.