极速成像技术测定高血压患者的脉搏波传导速度及相关影响因素

发布时间：2018-01-14 19:32

本文关键词：极速成像技术测定高血压患者的脉搏波传导速度及相关影响因素　出处：《中华高血压杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨极速成像技术测定高血压患者的脉搏波传导速度(PWV)及相关影响因素。方法选择南京中医药大学附属医院自2015年5月至2016年8月收治的高血压患者(高血压组)110例和同期体检健康者(对照组)78人,利用极速成像技术测量颈动脉弹性参数,包括收缩期开始时PWV(BS-PWV)和收缩期结束时PWV(ES-PWV)。测量两组颈动脉内膜中层厚度(IMT)。采用Bland-Altman方法对两位医师测量数据的一致性进行评估。比较两组受检者的性别、年龄构成、体质量指数(BMI)、收缩压、舒张压、BS-PWV、ES-PWV以及肌酐、尿酸、总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖和尿素氮水平。结果不同操作者测量的BS-PWV和ES-PWV数据具有较好的一致性。高血压组患者的年龄、BMI、收缩压、舒张压、三酰甘油、总胆固醇、空腹血糖、尿酸、肌酐、尿素氮、颈动脉IMT、BS-PWV及ES-PWV水平高于对照组(P0.05),而HDL-C水平低于对照组(P0.05)。随着血压分级的增加,颈动脉IMT、BS-PWV和ES-PWV在3组中呈增高趋势,高血压1、2级组间和1、3级组间IMT的差异有统计学意义,高血压1、3级组间BS-PWV的差异有统计学意义,而ES-PWV各组间差异均有统计学意义。Pearson相关分析显示,在全部受检者中,ES-PWV与年龄、收缩压、舒张压、三酰甘油、空腹血糖、尿酸呈正相关(r值分别为0.505、0.353、0.299、0.212、0.176、0.215,均P0.05),与HDL-C呈负相关(r=-0.221,P0.05);而BS-PWV与各因素均无明显相关性。多元线性逐步回归分析显示,年龄、舒张压、三酰甘油是ES-PWV的独立影响因素(β值分别为0.487、0.253和0.129,均P0.05)。结论高血压患者BS-PWV及ES-PWV值明显升高,且ES-PWV敏感性高于BS-PWV,可作为评价颈动脉弹性功能的指标。
[Abstract]:Objective to study the determination of pulse wave velocity in hypertensive patients with ultrafast imaging (PWV) and the related factors. Methods the Affiliated Hospital of Nanjing University of Chinese Medicine from May 2015 to August 2016 were patients with hypertension (hypertension group) of the 110 patients and healthy volunteers (control group) 78 people, using the speed to measure carotid elasticity imaging parameters, including systolic at the beginning of PWV (BS-PWV) and end systolic PWV (ES-PWV). The intima-media thickness of the carotid artery were measured in two groups (IMT). By using the Bland-Altman method of consistency of two doctors measured data for evaluation. The two groups were compared by gender, age, body mass index, systolic blood pressure (BMI). Diastolic blood pressure, BS-PWV, ES-PWV, creatinine, total cholesterol, uric acid, three triglyceride, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose and blood urea nitrogen levels. The fruit of different operators measured BS-PWV and ES-PWV data have good consistency. In patients with hypertension were age, BMI, systolic blood pressure, diastolic blood pressure, triglyceride three, total cholesterol, fasting blood glucose, uric acid, creatinine, urea nitrogen, carotid IMT, BS-PWV and ES-PWV were higher than that of control group (P0.05), and HDL-C the level is lower than the control group (P0.05). With the increase of blood pressure, carotid artery IMT, BS-PWV and ES-PWV in the 3 groups were increased, there were statistically significant differences in hypertension level 1,2 groups and 1,3 group IMT, there were statistically significant differences in hypertension level 1,3 groups BS-PWV, ES-PWV and correlation analysis between groups there were statistically significant differences in.Pearson showed that in all subjects, ES-PWV and age, systolic blood pressure, diastolic blood pressure, three triglycerides, fasting blood glucose, uric acid was positively correlated (r = 0.505,0.353,0.299,0.212,0.176,0.215, P0.05), and negatively correlated with HDL-C (r=-0.221 , P0.05); there was no significant correlation between BS-PWV and various factors. Multiple linear stepwise regression analysis showed that age, diastolic blood pressure, TG three was the independent factor of ES-PWV (beta = 0.487,0.253 and 0.129 respectively, P0.05). Conclusion the BS-PWV of patients with hypertension and ES-PWV increased obviously, and the sensitivity of ES-PWV was higher than that of BS-PWV. Can be used to evaluate the carotid artery elasticity index.

【作者单位】：南京中医药大学附属医院超声医学科;
【基金】：国家中医药管理局科研资助项目(JDZX2015104)
【分类号】：R445.1;R544.1
【正文快照】： 心血管病发病率逐年提高,主要原因是动脉硬化和高血压,发病早期,尽管患者还没有感觉到症状,但血管弹性、阻力和血液黏性等已发生了变化。脉搏波传导速度(pulse wave velocity,PWV)是反映动脉弹性的经典指标,PWV越快,动脉僵硬度越高,动脉弹性越差,可以很好地用于评价动脉壁扩张

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