超声评价原发性高血压不同危险性分层颈动脉弹性

发布时间：2018-07-25 12:18

【摘要】：目的探讨内-中膜厚度定量检测(QIMT)及动脉僵硬度定量检测(QAS)技术评价不同危险性分层原发性高血压患者颈动脉弹性的临床价值。方法将255例原发性高血压患者(高血压组)分为低危亚组31例,中危亚组48例,高危亚组67例,很高危亚组109例;另选70名健康成人作为正常对照组。应用QIMT软件测量颈总动脉内-中膜厚度(IMT),QAS软件测量颈总动脉弹性指标,包括僵硬度系数(α、β)、动脉扩张性系数(DC)、顺应性系数(CC)、脉搏波传导速度(PWV),并进行统计学分析。结果高血压组颈总动脉IMT、α、β及PWV大于对照组,DC及CC较对照组减小,差异均有统计学意义(P均0.001)。原发性高血压患者IMT、α、β及PWV均随危险性分层升高而增大,DC及CC随危险性分层升高而减小(P均0.001)。两两比较结果显示,除低危、中危两亚组间α及β差异无统计学意义(P均0.05)外,其余各指标在不同危险性分层亚组间差异均有统计学意义(P均0.05)。所有受试者PWV均与α、β、DC及CC相关(r=0.859、0.816、-0.703、-0.676),α均与β、DC及CC相关(r=0.976、-0.595、-0.478),β均与DC、CC相关(r=-0.579、-0.445),DC与CC相关(r=0.741,P均0.001)。IMT与PWV、α及β呈正相关(r=0.493、0.404、0.393),与DC、CC呈负相关(r=-0.516、-0.512,P均0.001)。结论原发性高血压患者颈动脉结构、弹性指标与危险性分层相关,QIMT及QAS技术可为高血压患者的危险性分层提供直接依据。
[Abstract]:Objective to evaluate the clinical value of quantitative measurement of intima-media thickness (QIMT) and arterial stiffness (QAS) in evaluating carotid artery elasticity in patients with different risk stratified essential hypertension. Methods 255 patients with essential hypertension (hypertension group) were divided into low risk subgroup (n = 31), middle risk subgroup (n = 48), high risk subgroup (n = 67) and very high risk subgroup (n = 109), and 70 healthy adults as normal control group. QIMT software was used to measure the common carotid artery intima-media thickness (IMT) and the common carotid artery elasticity, including stiffness coefficient (伪, 尾), arterial distensibility coefficient (DC),) compliance coefficient, (CC), pulse wave velocity (PWV),). Results IMT, 伪, 尾 and PWV of common carotid artery in hypertension group were lower than those in control group (P 0.001). IMT, 伪, 尾 and PWV in patients with essential hypertension increased with the increase of risk stratification and decreased with the increase of risk stratification (P 0.001). The results of pairwise comparison showed that there was no significant difference in 伪 and 尾 between the two subgroups except the low risk group and the middle risk subgroup (P 0.05), but the other indexes were significantly different among the different risk stratified subgroups (all P 0.05). In all subjects, PWV was correlated with 伪, 尾 -DC and CC (r = 0.8859 ~ (-1) -0.703 ~ (-0.676), 伪 with 尾 -DC and CC (r ~ (0.976) -0.595N ~ (-0.478), 尾 with CC (r ~ (0.5799-0.445) DC and CC (r ~ (0.741g) P ~ (0.001), 伪 and 尾 (r ~ (0.493n) 0.4040.393), and negatively with PWV (r = 0.516 ~ (-0.512) P = 0.001). Conclusion the carotid artery structure, elastic index and risk stratification are correlated with QIMT and QAS techniques in essential hypertension patients, which can provide a direct basis for risk stratification in patients with essential hypertension.
【作者单位】：西安交通大学第一附属医院超声科;宝鸡市中心医院超声医学科;
【分类号】：R544.1;R445.1

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