Analysis Of Hemodynamic Characteristics Of Cervical Arteries In The Normal Population By Ultrasound

Background and purposeCarotid artery hemodynamics is closely related to a variety of common diseases such as ischemic stroke,hypertension,arterial dissection,and takayasu arteritis.Hemodynamic changes are not only the result of disease,but also can be used for their diagnosis,Severity assessment and disease course judgment provide important reference value.The existing research objects of normal carotid artery hemodynamic reference values are mostly adults,and there is no clear report on the hemodynamics of the adolescents population.The adolescents are in the developmental stage,and each system is different from the adult's.The existing reference standards are unsuitable for the young people.In addition,there are many factors can influence on the hemodynamic parameters.Previous studies have suggested that various individual differences,including blood glucose,blood lipids,blood pressure,artery diameter,age,side and so on,can affect the determination of their normal values;new Parameters need to be sought that can reduce individual differences to improve the accuracy of diagnosis.The aim of this study was through measuring the carotid artery hemodynamic parameters of the normal population by carotid artery ultrasound examination,to analyze the influencing factors of the normal carotid artery hemodynamics,the characteristics of the normal juvenile carotid artery hemodynamics and The correlation between the difference in vertebral artery diameter and resistance index of the normal population,in order to obtain the characteristics of juvenile carotid artery hemodynamics and establish a predictive model of the difference in bilateral vertebral artery resistance index in the normal population,so as to reduce the influence of individual differences in hemodynamic,Improve its application value in disease diagnosis.Objects and methods:Collected 286 healthy controls who came to our hospital from November 2017 to November 2019 without cardio-cerebrovascular disease,including 140 males and 146 females,aged from 4 to 80 years old.Collect the clinical data and laboratory test results of the examines,and perform ultrasound examination of the carotid vascular at the same time to measure the diameter(D),peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI)of the internal carotid artery and vertebral artery.The above measurements are averaged three times,and all are done by the same doctor on the same machine.Calculate the difference between the diameter of the bilateral arteries(?DL-R=DL-DR)and the diameter ratio(DL/R=DL/DR),the difference of the resistance index of the ipsilateral vertebral artery and internal carotid artery(?RIVA-ICA=RIVA-RIICA),the difference of Bilateral carotid artery resistance index(?RIR-L=RIR-RIL),and resistance index ratio(RIR/L=RIR/RIL).The result1 Analysis of factors affecting hemodynamic parameters1.1 General information and hemodynamic parametersCarotid artery diameter is related to gender;Hemodynamics are related to gender,blood pressure,blood glucose,blood lipids,and diameter.Male internal carotid artery diameter and vertebral artery diameter are larger than female,bilateral internal carotid artery,bilateral vertebral artery PSV,bilateral internal carotid artery EDV and left vertebral artery EDV are lower than female(P<0.05);Blood pressure,blood lipid,and blood glucose are all influencing factors of internal carotid artery blood flow velocity(P<0.05);blood pressure and blood lipid are influencing factors of internal carotid artery RI(P<0.05);blood pressure,blood lipid,and diameter are the effects of vertebral artery RI Factors(P<0.05)1.2 Comparison of carotid artery hemodynamic parameters between different age groupsThere were no statistically significant differences in the bilateral internal carotid artery and vertebral artery PSV between the 20-40 year old group,the 40-60 year old group,and the>60 year old group(P>0.05),but they were all less than the<20 year old group(P<0.05);Both the internal carotid artery EDV and the left vertebral artery EDV of the 40-60 year old group,?60 year old group are less than the<20 year old group,20-40 year old group(P<0.05);The RI of the arteries and vertebral arteries of<20 year old group,?60 year old group was higher than those of the 20-40 year old group and the 40-60 year old group(P<0.05).2 Hemodynamic of adolescent group(<20 years old group)2.1 Comparison of hemodynamic between pre-pubertal group(less than or equal to 10 years old)and puberty group(more than 10 years old and less than or equal to 20 years old)The diameter of bilateral internal carotid artery in puberty group was larger than that in pre-pubertal group(P<0.05);the bilateral internal carotid artery PSV,EDV and bilateral vertebral artery PSV,EDV,RI were lower than that in pre-pubertal group(P<0.05);two There was no statistically significant difference in bilateral internal carotid artery RI and bilateral vertebral artery diameter between groups(P>0.05).2.2 Height,BMI and hemodynamic of adolescent groupThere was no statistically significant difference in hemodynamic among the short group,normal group and super high group(P>0.05).BMI was negatively correlated with bilateral vertebral artery and internal carotid artery PSV,EDV,RI(P<0.05).2.3 Comparison of RI of ipsilateral vertebral artery and internal carotid arteryThe RI of bilateral.vertebral arteries in pre-pubertal group and pubertal group was greater than that of ipsilateral internal carotid artery(P<0.05).The ? RIVA-ICA on the left side of the puberty group was lower than that of the pre-pubertal group(P<0.05);there was no significant difference in the right ?RIVA-ICA between the two groups(P>0.05).3 Difference analysis of related parameters of bilateral carotid artery resistance indexBilateral internal carotid artery,vertebral artery ADL-R,DL/R ?RIR-L and RIR/L between different genders and different age groups were not statistically significant(P>0.05).and not affected by blood pressure,blood sugar,blood lipid(P>0.05).The bilateral vertebral artery ?DL-R is not only significantly related to ?RIR-L and RIR/L but an independent influencing factor of ARIR-L and RIR/L showed by the stepwise regression analysis method.The regression equation is as follows:?RIR-L=0.058 ×?DL-R-0.013,RIR/L=0.093 × ? DL-R+0.987.conclusionCompared with adults,the blood flow velocity of the internal carotid artery and vertebral artery of normal adolescenst is faster,the resistance index is higher and the changes are not completely synchronized.When performing ultrasound evaluation of cervical vessels in adolescents,the influence of growth and development of the adolescents should be fully considered.The hemodynamics of bilateral carotid arteries are affected by many factors,Especially the vertebral artery,and there are certain errors in evaluating the blood flow status based on fixed reference values.In this study,bilateral vertebral artery ARIR-L and RIR/L are only related to bilateral vertebral artery ?DL-R,and ?DL-R is an independent influencing factor of both,and the method of predicting the resistance index difference of bilateral vertebral artery by ?DL-R helps to more comprehensively evaluate bilateral vertebral artery blood flow.