原发性高血压病和冠心病患者的脉搏波传导速度分析

发布时间：2018-05-18 01:23

本文选题：脉搏波传导速度 + 高血压　；参考：《兰州大学》2015年硕士论文

【摘要】：背景：目前脉搏波传导速度(pulse wave velocity, PWV)被看作是动脉硬化病变的一个标志物,研究结果显示PWV在高血压病、冠心病等心血管疾病的危险分层和疾病预后判断中具有重要的临床应用价值。2013年的欧洲高血压管理指南中将颈-股动脉脉搏波传导速度(cfPWV)列为评价高血压患者靶器官损害的一项指标。PWV的影响因素除了动脉血管壁自身的性质外,年龄、心率、血压、血脂等也能影响PWV。目的：分析原发性高血压病和冠心病患者PWV的临床特点、影响因素和PWV对冠心病的预测价值。方法：共收集201名接受冠脉造影检查的住院患者作为本次研究的研究对象,根据造影结果分为四组：正常对照组、高血压组、单纯冠心病组、冠心病合并高血压组。收集一般临床资料；空腹抽血检测生化指标；测定PWV。结果：(1)四组间的cfPWV和cdPWV比较差异有统计学意义,高血压组、单纯冠心病组和冠心病合并高血压组的cfPWV及cdPWV较正常对照组显著升高,crPWV在四组间的比较无统计学差异；(2)高血压组和单纯冠心病组间的cfPWV和cdPWV比较无统计学差异,冠心病合并高血压组的cfPWV则要高于高血压组和单纯冠心病组(P0.05),高血压组和冠心病合并高血压组的cdPWV要高于正常对照组；(3)每组内crPWV、cdPWV和cfPWV三组数据的比较差异有统计学意义(P0.05)；(4)SBP、年龄、Hcy、GLU是cfPWV的影响因素；MAP、年龄和BUN是cdPWV的影响因素；(5) cfPWV为9.6m/s时预测冠心病的特异度为46.15%,灵敏度为91.67%。结论：原发性高血压病、冠心病患者的PWV明显高于正常人群,冠心病合并高血压患者的PWV较高血压病患者和单纯冠心病患者显著加快；cfPWV在动脉硬化检测中具有更高的临床应用价值,其诊断冠心病的敏感性高,但特异性低；SBP、MAP、年龄、Hcy、GLU和BUN是PWV的影响因素。
[Abstract]:Background: at present, pulse wave velocity, PWV) is regarded as a marker of arteriosclerosis. The results show that PWV plays an important role in hypertension. Risk stratification and prognosis of cardiovascular diseases such as coronary heart disease have important clinical application value. In 2013 European hypertension management guidelines included carotid artery pulse wave velocity (PWV) as a target for evaluating hypertensive patients. An indicator of organ damage, PWV, in addition to the nature of the arterial wall itself, Age, heart rate, blood pressure and blood lipids can also affect PWV. Objective: to analyze the clinical characteristics, influencing factors and predictive value of PWV in patients with essential hypertension and coronary heart disease (CHD). Methods: 201 inpatients who received coronary angiography were divided into four groups: normal control group, hypertension group, coronary heart disease group and coronary heart disease complicated with hypertension group. General clinical data were collected, biochemical indexes were detected by fasting blood sampling, PWV was measured. Results the differences of cfPWV and cdPWV among the four groups were statistically significant. The levels of cfPWV and cdPWV in CHD group and CHD with hypertension group were significantly higher than those in normal control group. There was no significant difference in cfPWV and cdPWV between hypertension group and coronary heart disease group (2) there was no significant difference in cfPWV and cdPWV between hypertension group and coronary heart disease group. The cfPWV of coronary heart disease with hypertension group was higher than that of hypertension group and pure coronary heart disease group (P 0.05). The cdPWV of hypertension group and coronary heart disease complicated with hypertension group was higher than that of normal control group. The clinical significance was P0.05 / 4SBP, the age of Hcyl GLU was the influencing factor of cfPWV, and the age and BUN were the influencing factors of cdPWV. The specificity of predicting coronary heart disease (CHD) was 46.15 when cfPWV was 9.6m/s, and the sensitivity was 91.67. The results were as follows: (1) when cfPWV was 9.6m/s, the specificity of predicting coronary heart disease was 46.15, and the sensitivity was 91.67. Conclusion: the PWV of patients with essential hypertension and coronary heart disease is significantly higher than that of normal people. Compared with the patients with hypertension and simple coronary heart disease, PWV has a higher clinical application value in the detection of arteriosclerosis, and its sensitivity in the diagnosis of coronary heart disease is higher than that in the patients with coronary heart disease and simple coronary heart disease. But the specificity of PWV was low, the age of Hcy GLU and BUN were the influencing factors of PWV.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4;R544.11

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