本文選題：脈搏波傳導(dǎo)速度 + 高血壓�。� 參考：《蘭州大學(xué)》2015年碩士論文

【摘要】：背景：目前脈搏波傳導(dǎo)速度(pulse wave velocity, PWV)被看作是動脈硬化病變的一個標(biāo)志物,研究結(jié)果顯示PWV在高血壓病、冠心病等心血管疾病的危險分層和疾病預(yù)后判斷中具有重要的臨床應(yīng)用價值。2013年的歐洲高血壓管理指南中將頸-股動脈脈搏波傳導(dǎo)速度(cfPWV)列為評價高血壓患者靶器官損害的一項指標(biāo)。PWV的影響因素除了動脈血管壁自身的性質(zhì)外,年齡、心率、血壓、血脂等也能影響PWV。目的：分析原發(fā)性高血壓病和冠心病患者PWV的臨床特點、影響因素和PWV對冠心病的預(yù)測價值。方法：共收集201名接受冠脈造影檢查的住院患者作為本次研究的研究對象,根據(jù)造影結(jié)果分為四組：正常對照組、高血壓組、單純冠心病組、冠心病合并高血壓組。收集一般臨床資料；空腹抽血檢測生化指標(biāo)；測定PWV。結(jié)果：(1)四組間的cfPWV和cdPWV比較差異有統(tǒng)計學(xué)意義,高血壓組、單純冠心病組和冠心病合并高血壓組的cfPWV及cdPWV較正常對照組顯著升高,crPWV在四組間的比較無統(tǒng)計學(xué)差異；(2)高血壓組和單純冠心病組間的cfPWV和cdPWV比較無統(tǒng)計學(xué)差異,冠心病合并高血壓組的cfPWV則要高于高血壓組和單純冠心病組(P0.05),高血壓組和冠心病合并高血壓組的cdPWV要高于正常對照組；(3)每組內(nèi)crPWV、cdPWV和cfPWV三組數(shù)據(jù)的比較差異有統(tǒng)計學(xué)意義(P0.05)；(4)SBP、年齡、Hcy、GLU是cfPWV的影響因素；MAP、年齡和BUN是cdPWV的影響因素；(5) cfPWV為9.6m/s時預(yù)測冠心病的特異度為46.15%,靈敏度為91.67%。結(jié)論：原發(fā)性高血壓病、冠心病患者的PWV明顯高于正常人群,冠心病合并高血壓患者的PWV較高血壓病患者和單純冠心病患者顯著加快；cfPWV在動脈硬化檢測中具有更高的臨床應(yīng)用價值,其診斷冠心病的敏感性高,但特異性低；SBP、MAP、年齡、Hcy、GLU和BUN是PWV的影響因素。
[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.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.4;R544.11

【參考文獻(xiàn)】

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1 高明;李偉哲;李冬青;王艷秀;孫玉艷;劉英;趙劍秋;陳朔華;韓紅鋒;趙性泉;吳壽嶺;;基線高敏C反應(yīng)蛋白水平對臂踝脈搏波傳導(dǎo)速度的影響[J];中國動脈硬化雜志;2014年01期

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