透過您的圖書館登入
IP:3.237.46.120
  • 期刊

鼻咽癌患者經放射治療後的頸動脈超音波檢查結果

Carotid Doppler Findings in Nasopharyngeal Carcinoma Patients after Radiotherapy

摘要


背景:頸動脈狹窄及動脈粥狀硬化會增加缺血性中風、心肌梗塞之機率。本研究的目的爲評估鼻咽癌患者經放射治療後,頸動脈狹窄的發生率及頸動脈內中膜厚度增厚的程度。 方法:自2007年1月至2007年12月於門診追蹤的鼻咽癌患者中,經放射線治療完成2年以上,排除局部復發與遠處轉移者,安排頸動脈超音波檢查,接受檢查者共31名爲實驗組,同一年間接受頸動脈超音波健康檢查且未接受過放射治療的民眾,隨機選取31名爲對照組,比較兩組頸動脈狹窄的比例及程度、動脈壁內中膜的厚度以及顱外椎體動脈的流速等,並分析與動脈狹窄相關的危險因子,如高血壓、糖尿病、心臟病、高膽固醇血症、肥胖、及抽煙等。 結果:實驗組與對照組在年齡、性別及可能造成血管狹窄或硬化的危險因子如高血壓、糖尿病、心臟病、高膽固醇血症、肥胖、及抽煙等皆無統計學上的差異,實驗組動脈壁內中膜的厚度異常增厚共有8名(25.8%)、對照組2名(6.5%),實驗組動脈壁內中膜最大厚度的平均,右側爲0.69mm、左側爲0.73mm,對照組右側爲0.60mm、左側爲0.61mm。實驗組頸動脈管徑狹窄>30%者有8名(25.8%),多於對照組的4名(12.9%),實驗組頸動脈截面積狹窄>30%者有7名(22.6%),多於對照組的1名(3.2%)。比較實驗組與對照組顱外椎體動脈的阻礙係數,顯示實驗組顱外椎體動脈的血流並無異常的阻塞。另外,針對與動脈狹窄相關的危險因子做分析,顯示年齡、高血壓具統計上的意義,與內中膜異常增厚相關的危險因子做分析,顯示年齡具統計上的意義。 結論:頸部的放射治療會加速頸動脈的硬化與狹窄,針對鼻咽癌患者中具心血管危險因子的族群,建議實施常規頸動脈超音波檢查,提早發現病患頸動脈狹窄及動脈內中膜增厚的程度,期能降低將來動脈粥狀硬化及缺血性中風之機率。

並列摘要


BACKGROUND: Radiation-induced carotid stenosis and atherosclerotic lesions in patients with head and neck tumors can cause significant morbidity and mortality. The purpose of this study was to perform and present carotid Doppler findings in patients with nasopharyngeal carcinoma who had received radiation therapy. METHODS: Thirty-one patients who had completed cervical radiotherapy more than 2 years previously were asked to undergo carotid Doppler examination between January and December 2007. We excluded patients who had locoregional recurrence or distant metastasis. In addition, 31 healthy individuals without a history of radiotherapy were examined as controls. Statistical analysis compared the two groups with regard to degree of carotid stenosis, intima-media thickness (IMT), velocity of vertebral arteries, and related comorbidity data (including sex, age, presence of hypertension, diabetes mellitus, heart disease, or hypercholesterolemia, as well as obesity and smoking). RESULTS: There were no significant differences in comorbidities between groups. Abnormally large IMT values were increased in patients compared with controls. A significant increase in IMT was observed on both the left (0.73 vs. 0.61 mm, p=0.012) and right (0.69 vs. 0.60mm, p=0.031) sides. Patients had a higher prevalence of carotid stenosis per both luminal diameter and cross-sectional area (25.8% vs. 12.9% and 22.6% vs. 3.2%, respectively). Radiation-induced carotid stenosis was associated with increased age and history of hypertension. Abnormal IMT was associated with increased age. CONCLUSIONS: Patients who have undergone cervical radiotherapy have a higher risk of developing carotid stenosis and an accelerated increase in IMT.

延伸閱讀