發(fā)布時(shí)間：2018-01-14 19:32

  本文關(guān)鍵詞：極速成像技術(shù)測(cè)定高血壓患者的脈搏波傳導(dǎo)速度及相關(guān)影響因素　出處：《中華高血壓雜志》2017年05期 　論文類(lèi)型：期刊論文

  更多相關(guān)文章： 極速成像技術(shù) 脈搏波傳導(dǎo)速度 頸動(dòng)脈彈性 高血壓

【摘要】：目的探討極速成像技術(shù)測(cè)定高血壓患者的脈搏波傳導(dǎo)速度(PWV)及相關(guān)影響因素。方法選擇南京中醫(yī)藥大學(xué)附屬醫(yī)院自2015年5月至2016年8月收治的高血壓患者(高血壓組)110例和同期體檢健康者(對(duì)照組)78人,利用極速成像技術(shù)測(cè)量頸動(dòng)脈彈性參數(shù),包括收縮期開(kāi)始時(shí)PWV(BS-PWV)和收縮期結(jié)束時(shí)PWV(ES-PWV)。測(cè)量?jī)山M頸動(dòng)脈內(nèi)膜中層厚度(IMT)。采用Bland-Altman方法對(duì)兩位醫(yī)師測(cè)量數(shù)據(jù)的一致性進(jìn)行評(píng)估。比較兩組受檢者的性別、年齡構(gòu)成、體質(zhì)量指數(shù)(BMI)、收縮壓、舒張壓、BS-PWV、ES-PWV以及肌酐、尿酸、總膽固醇、三酰甘油、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、空腹血糖和尿素氮水平。結(jié)果不同操作者測(cè)量的BS-PWV和ES-PWV數(shù)據(jù)具有較好的一致性。高血壓組患者的年齡、BMI、收縮壓、舒張壓、三酰甘油、總膽固醇、空腹血糖、尿酸、肌酐、尿素氮、頸動(dòng)脈IMT、BS-PWV及ES-PWV水平高于對(duì)照組(P0.05),而HDL-C水平低于對(duì)照組(P0.05)。隨著血壓分級(jí)的增加,頸動(dòng)脈IMT、BS-PWV和ES-PWV在3組中呈增高趨勢(shì),高血壓1、2級(jí)組間和1、3級(jí)組間IMT的差異有統(tǒng)計(jì)學(xué)意義,高血壓1、3級(jí)組間BS-PWV的差異有統(tǒng)計(jì)學(xué)意義,而ES-PWV各組間差異均有統(tǒng)計(jì)學(xué)意義。Pearson相關(guān)分析顯示,在全部受檢者中,ES-PWV與年齡、收縮壓、舒張壓、三酰甘油、空腹血糖、尿酸呈正相關(guān)(r值分別為0.505、0.353、0.299、0.212、0.176、0.215,均P0.05),與HDL-C呈負(fù)相關(guān)(r=-0.221,P0.05);而B(niǎo)S-PWV與各因素均無(wú)明顯相關(guān)性。多元線性逐步回歸分析顯示,年齡、舒張壓、三酰甘油是ES-PWV的獨(dú)立影響因素(β值分別為0.487、0.253和0.129,均P0.05)。結(jié)論高血壓患者BS-PWV及ES-PWV值明顯升高,且ES-PWV敏感性高于BS-PWV,可作為評(píng)價(jià)頸動(dòng)脈彈性功能的指標(biāo)。
[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.

【作者單位】： 南京中醫(yī)藥大學(xué)附屬醫(yī)院超聲醫(yī)學(xué)科;
【基金】：國(guó)家中醫(yī)藥管理局科研資助項(xiàng)目(JDZX2015104)
【分類(lèi)號(hào)】：R445.1;R544.1
【正文快照】： 心血管病發(fā)病率逐年提高,主要原因是動(dòng)脈硬化和高血壓,發(fā)病早期,盡管患者還沒(méi)有感覺(jué)到癥狀,但血管彈性、阻力和血液黏性等已發(fā)生了變化。脈搏波傳導(dǎo)速度(pulse wave velocity,PWV)是反映動(dòng)脈彈性的經(jīng)典指標(biāo),PWV越快,動(dòng)脈僵硬度越高,動(dòng)脈彈性越差,可以很好地用于評(píng)價(jià)動(dòng)脈壁擴(kuò)張

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