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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2020, Vol. 17 ›› Issue (01) : 46 -51. doi: 10.3877/cma.j.issn.1672-6448.2020.01.009

所属专题： 文献；

外周血管超声影像学

运动员下肢动脉血管的高频超声特征
梅艳1, 张震2, 赵凯军3,†()   
  1. 1. 010017　呼和浩特，内蒙古自治区人民医院健康管理中心（体检中心）
    2. 010059　呼和浩特，内蒙古医科大学附属医院胃肠外科
    3. 130033　长春，吉林大学中日联谊医院超声科
  • 收稿日期:2019-04-28 出版日期:2020-01-01
  • 通信作者: 赵凯军

High frequency ultrasound for comparing characteristics of lower limb arteries between athletes and normal people

Yan Mei1, Zhen Zhang2, Kaijun Zhao3,†()   

  1. 1. Health Management Center (Medical Center), Inner Mongolia Autonomous People′s Hospital, Hohhot 010017, China
    2. Deportment of Gastrointestinal Surgery, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, China
    3. Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun 130033, China
  • Received:2019-04-28 Published:2020-01-01
  • Corresponding author: Kaijun Zhao
  • About author:
    Corresponding author: Zhao Kaijun, Email:
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引用本文：

梅艳, 张震, 赵凯军. 运动员下肢动脉血管的高频超声特征[J]. 中华医学超声杂志（电子版）, 2020, 17(01): 46-51.

Yan Mei, Zhen Zhang, Kaijun Zhao. High frequency ultrasound for comparing characteristics of lower limb arteries between athletes and normal people[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(01): 46-51.

目的

探讨运动员与正常人下肢动脉的高频超声特征差异，以及运动时间对下肢动脉超声特征的影响，引导人们进行健康的生活方式。

方法

选取2015年7月至2016年3月期间就职于当地体育局及就读于体育学院的职业长、短跑及自行车运动员为实验组，共96人，从事体育训练时间5个月~11年不等，另选取同时间段同年龄段的无运动习惯的健康青年人108人作为对照组。对受检者分别行胫前动脉、胫后动脉及腓动脉的超声影像学检查，观察并测量血管内径（ID）及内膜-中层厚度（IMT）。实验组与对照组的内径及IMT比较采用t检验，性别构成比采用χ2检验，实验组A、B、C组的内径及IMT组间比较采用方差分析，两两之间比较采用LSD-t法。

结果

对胫前动脉、胫后动脉、腓动脉左右两侧的内径及IMT比较显示实验组及对照组的上述动脉左右两侧，差异均无统计学意义（P>0.05）。对胫前动脉、胫后动脉及腓动脉实验组与对照组内径及IMT比较，可见两组间的胫前动脉内径与IMT、胫后动脉内径与IMT、腓动脉内径与IMT比较，差异均有统计学意义（t=-3.323、4.488、2.245、5.834、-3.692、3.210，P均<0.05），实验组内径大于对照组，实验组IMT小于对照组。对实验组胫前动脉、胫后动脉、腓动脉不同运动时间的内径及IMT比较发现，胫前动脉内径与IMT、胫后动脉内径与IMT、腓动脉内径与IMT在不同运动时间之间的比较，差异均有统计学意义（F=6.237、9.902、8.293、25.814、9.444、6.572，P均<0.01），进一步两两比较，胫前动脉及胫后动脉内径在A组与B组、腓动脉IMT在A组与B组间，差异均无统计学意义（P均>0.05），余动脉各组间比较差异均有统计学意义（P均<0.05）。

结论

下肢运动训练可使动脉管径增大，减小动脉IMT，且在达到一定的运动时间以及强度情况下，随着运动时间延长，动脉管径逐渐增大，动脉IMT逐渐减小，进而延缓动脉粥样硬化进程。

关键词: 超声检查, 运动员, 下肢动脉, 内径, 内膜-中层厚度
Objective

To compare the difference of high-frequency ultrasound characteristics of lower limb arteries between athletes and normal people, and explore the effect of exercise time on the ultrasonic characteristics of lower limb arteries, so as to guide people to live a healthy lifestyle.

Methods

A total of 96 professional long-distance runners, short-distance runners, and cyclists who worked in the local sports bureau and the sports college from July 2015 to March 2016 and were engaged in sports training ranging from 5 months to 11 years were selected as an experimental group. Another 108 healthy young people without exercise habits were selected as a control group. The ultrasound diagnostic instrument American GE LOGIQ-7 was used to examine the anterior tibial artery, posterior tibial artery, and peroneal artery of the subjects and measure the blood vessel inner diameter (ID) and intima-media thickness (IMT). SPSS19.0 statistical software package was used for data analysis. The data were tested for normality and homogeneity of variance. Measurement data such as ID and IMT are expressed as the mean ± standard deviation and were compared using the t-test. Count data such as sex composition are expressed as percentages and were compared using the χ2 test. The comparisons of ID and IMT among the experimental subgroups A, B, and C were performed by analysis of variance, followed by pairwise comparisons between groups by the LSD method.

Results

There were no significant differences in the ID or IMT of the anterior tibial artery, posterior tibial artery, and peroneal artery between the two sides in both groups (P>0.05). The ID and IMT of the tibial artery (t=-3.323, 4.488, all P<0.05), posterior tibial artery (t=2.245, 5.834, all P<0.05), and peroneal artery (t=-3.692, 3.210, P<0.05) differed significantly between the two groups; the ID was larger and the IMT was smaller in the experimental group than in the control group. The ID and IMT of the anterior tibial artery (F=6.237, 9.902, all P<0.01), posterior tibial artery (F=8.293, 25.814, P<0.01), and peroneal artery (F=9.444, 6.572, P<0.01) differed significantly among different exercise time points, and there were also significant differences (P<0.05) in pairwise comparisons except the internal diameter of the anterior tibial artery and posterior tibial artery between groups A and B, and the peroneal artery IMT between groups A and B (P>0.05).

Conclusion

Lower limb exercise training can increase the diameter and reduce the intima-middle thickness of the artery. Moreover, when a certain extent of exercise time and intensity are reached, the arterial diameter will gradually increase and intima-middle thickness will gradually decrease with the extension of exercise time, thus delaying the process of atherosclerosis.

Key words: Ultrasonography, Athlete, Lower extremity artery, Inner diameter, Intimal medial thickness
表1 受检者基本信息
组别 例数 性别（男/女） 年龄（岁，±s） BMI（kg/m2，±s）
实验组 96 54/42 21.20±2.997 20.62±1.519
对照组 108 50/58 22.08±3.429 21.07±2.153
统计值 ? χ2=2.015 t=1.952 t=1.732
P值 ? 0.156 0.052 0.085
表2 实验组3条动脉左右两侧内径及IMT的比较（±s）
组别 ATA PTA PEA
内径 IMT 内径 IMT 内径 IMT
右侧 0.269±0.0340 0.046±0.0089 0.225±0.0319 0.048±0.0096 0.267±0.0315 0.047±0.0089
左侧 0.271±0.0271 0.046±0.0080 0.227±0.0279 0.047±0.0077 0.270±0.0340 0.047±0.0085
t值 -0.863 -0.283 -1.328 0.872 -1.342 0.336
P值 0.391 0.778 0.187 0.386 0.183 0.738
表3 对照组3条动脉左右两侧内径及IMT的比较（±s）
组别 ATA PTA PEA
内径 IMT 内径 IMT 内径 IMT
右侧 0.258±0.0485 0.050±0.0090 0.217±0.0420 0.052±0.0067 0.258±0.0470 0.050±0.0068
左侧 0.253±0.0579 0.050±0.0098 0.219±0.0387 0.053±0.0069 0.251±0.0449 0.050±0.0088
t值 0.687 -0.250 -0.616 -0.776 1.684 -0.115
P值 0.494 0.803 0.539 0.439 0.095 0.909
表4 三条动脉实验组与对照组内径及IMT的比较（±s）
组别 例数 ATA PTA PEA
内径 IMT 内径 IMT 内径 IMT
实验组 96 0.270±0.0307 0.046±0.0085 0.23±0.030 0.048±0.0087 0.269±0.0327 0.047±0.0087
对照组 108 0.256±0.0533 0.050±0.0094 0.22±0.040 0.052±0.0068 0.254±0.0460 0.050±0.0079
t值 ? -3.323 4.488 2.245 5.834 -3.692 3.210
P值 ? 0.001 <0.001 0.025 <0.001 <0.001 0.001
表5 三条动脉不同运动时间的内径及IMT比较（±s）
指标 例数 ATA PTA PEA
内径 IMT 内径 IMT 内径 IMT
A组 70 0.27±0.033 0.049±0.0075 0.22±0.032 0.052±0.0082 0.26±0.040 0.049±0.0080
B组 76 0.27±0.030 0.046±0.0084a 0.22±0.025 0.047±0.0071a 0.27±0.032a 0.047±0.0094
C组 46 0.28±0.024bc 0.042±0.0085bc 0.24±0.029bc 0.042±0.0081bc 0.28±0.045bc 0.044±0.0074bc
F值 ? 6.237 9.902 8.293 25.814 9.444 6.572
P值 ? 0.002 <0.001 <0.001 <0.001 <0.001 0.002
图1 胫前动脉中段超声图像。图a为从业10年男性运动员胫前动脉中段，内径0.43 cm，内膜-中层厚度为0.04 cm；图b为对照组同龄男性胫前动脉中段，内径0.26 cm，内膜-中层厚度为0.05 cm
图2 胫后动脉下段超声图像。图a为从业5年女性运动员胫后动脉下段，内径0.25 cm，内膜-中层厚度为0.04 cm；图b为对照组同龄女性胫后动脉下段，内径0.21 cm，内膜-中层厚度为0.06 cm
图3 腓动脉上段超市个图像。图a为从业2年女性运动员腓动脉上段，内径0.28 cm，内膜-中层厚度为0.05 cm；图b为对照组同龄女性腓动脉动脉上段，内径0.24 cm，内膜-中层厚度为0.04 cm
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