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目的观察美国黑人青年长期应用可卡因对其颈内动脉管径变化的影响。方法对美国巴尔地摩市57名可能有应用可卡因历史的黑人青年进行问卷调查,同时抽血检测血常规、血脂、C反应蛋白(CRP),并行颈内动脉核磁共振检查(MRI)以了解颈内动脉结构的变化情况。应用多元回归模型分析颈内动脉管径变化与应用可卡因的关系。结果在应用可卡因的患者(n=40)CRP及白细胞总数WBC(1×109/L)较未应用过可卡因的患者(n=17)均略有升高[(5.14±12.31)vs(1.29±0.92)μg/L,P=0.059及(5.03±1.70)vs(4.12±1.22),P=0.059],而平均红细胞容积(MCH)和平均红血球浓度(MCHC)稍低于未用过可卡因的患者[(29.34±2.18)vs(31.77±4.50)pg,P=0.055及(33.23±0.75)vs(33.67±0.49)g/dl,P=0.38],但均无显著差别。平均颈内动脉壁厚度(MTICV)可卡因组与无可卡因组未见显著差别[(0.952±0.244)vs(0.968±0.275)cm,P=0.822],颈内动脉壁增厚者(MTICV>1.0 cm)比例两组无显著差别(25.0%vs29.4%,P=0.729);应用单变量线性回归模型分析,可见颈内动脉水平测量外径(HOD)、垂直内径(VID)、外轮廓面积(OA)、颈内动脉内轮廓面积(ILA)、外轮廓体积(OV)、内径轮廓体积(LV)与应用可卡因呈显著负相关。应用多变量回归模型分析,可见颈内动脉的HOD,VID,OA,ILA,OV,LV仅与应用可卡因呈现显著负相关,而颈内动脉的管径变化与年龄、性别、身高体质量指数(BMI)、CRP、HIV感染无相关性。结论长期慢性应用可卡因可造成颈内动脉的缩窄。由于动脉长期缩窄可引起动脉缺血和动脉粥样硬化,由此或可推论长期慢性应用可卡因引起的颈内动脉收缩也许是动脉粥样硬化最初表现的形式。
Objective To observe the long-term use of cocaine in African-American youth on the change of its internal carotid artery diameter. Methods A total of 57 black young people who may have history of cocaine use in Baltimore City of the United States were surveyed by questionnaire. Blood samples were collected for blood routine examination, blood lipids, C-reactive protein (CRP), and internal carotid artery magnetic resonance imaging (MRI) Internal arterial structure changes. The relationship between the change of internal carotid artery diameter and cocaine application by multivariate regression model. Results Patients with cocaine (n = 40) had a slightly higher CRP and WBC (1 × 109 / L) than those without cocaine (n = 17) (n = 40 vs 5.14 ± 12.31 vs 1.29 ± 0.92) μg / L, P = 0.059 and (5.03 ± 1.70 vs 4.12 ± 1.22, P = 0.059 respectively), while the mean erythrocyte volume (MCH) and mean erythrocyte concentration [(29.34 ± 2.18) vs (31.77 ± 4.50) pg, P = 0.055 and (33.23 ± 0.75) vs (33.67 ± 0.49) g / dl, P = 0.38] The average carotid artery wall thickness (MTICV) had no significant difference between cocaine group and no cocaine group [(0.952 ± 0.244) vs (0.968 ± 0.275) cm, P = 0.822] ) Were not significantly different between the two groups (25.0% vs 29.4%, P = 0.729). Univariate linear regression analysis showed that the internal carotid artery (HOD), vertical internal diameter (VID) OA), internal carotid artery area (ILA), outer contour volume (OV), inner diameter contour volume (LV) and application of cocaine were significantly negatively correlated. Multivariate regression model analysis showed that internal carotid artery HOD, VID, OA, ILA, OV, LV and application of cocaine showed only a significant negative correlation, while changes in the diameter of the internal carotid artery and age, sex, body mass index BMI), CRP, HIV infection no correlation. Conclusion Chronic use of cocaine can cause narrowing of the internal carotid artery. As long-term arterial constriction can cause arterial ischemia and atherosclerosis, it can be inferred that long-term chronic cocaine-induced carotid artery contractions may be the first manifestation of atherosclerosis.