Статья
Диагностика субклинического атеросклероза как элемент современной стратегии стратификации сердечнососудистого риска
Стратификация сердечно-сосудистого риска (ССР) играет важную роль в первичной профилактике атеросклероза и связанных с ним заболеваний. Общепринятые системы расчета ССР (Фремингамская шкала риска, шкала SCORE и др.), предполагающие оценку ограниченного количества традиционных факторов риска (ФР), не дают возможности с высокой точностью рассчитывать индивидуальный риск и осуществлять эффективные профилактические мероприятия. Одним из способов оптимизации оценки ССР является диагностика субклинического атеросклероза, основанная на прямой визуализации преклинических атеросклеротических изменений в стенках артерий. Ультразвуковое исследование (УЗИ) экстракраниальных сегментов сонных артерий (СА) с оценкой толщины комплекса интима-медиа (ТКИМ) и атеросклеротических бляшек (АБ) является важным методом такой диагностики. В обзоре обсуждаются патогенетические механизмы утолщения КИМ, стандарты УЗ оценки ТКИМ и интерпретации полученных результатов, их значимость для оптимизации расчета ССР.
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