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中华医学超声杂志（电子版） ›› 2019, Vol. 16 ›› Issue (09) : 671 -675. doi: 10.3877/cma.j.issn.1672-6448.2019.09.006

所属专题： 文献；

头颈部超声影像学

极速脉搏波技术评价单纯收缩期高血压患者颈动脉弹性
付伟1, 李劼1, 马琳1,†(), 阚艳敏1   
  1. 1. 河北唐山　063000，华北理工大学附属医院超声科
  • 收稿日期:2018-10-12 出版日期:2019-09-01
  • 通信作者: 马琳
  • 基金资助:
    中国超声医师科技新星计划课题(2017005)

Evaluation of carotid arterial elasticity using ultrafast pulse wave velocity in patients with isolated systolic hypertension

Wei Fu1, Jie Li1, Lin Ma1,†(), Yanmin Kan1   

  1. 1. Department of Ultrasound, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, China
  • Received:2018-10-12 Published:2019-09-01
  • Corresponding author: Lin Ma
  • About author:
    Corresponding author: Ma Lin, Email:
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付伟, 李劼, 马琳, 阚艳敏. 极速脉搏波技术评价单纯收缩期高血压患者颈动脉弹性[J]. 中华医学超声杂志（电子版）, 2019, 16(09): 671-675.

Wei Fu, Jie Li, Lin Ma, Yanmin Kan. Evaluation of carotid arterial elasticity using ultrafast pulse wave velocity in patients with isolated systolic hypertension[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(09): 671-675.

目的

应用极速脉搏波技术（UFPWV）评价单纯收缩期高血压（ISH）患者、双期高血压（SDH）患者颈总动脉弹性情况；比较UFPWV技术所检测的颈总动脉前壁心脏收缩起始脉搏波速度（BS）、心脏收缩末期脉搏波速度（ES）值与传统颈总动脉内中膜厚度（IMT）值在早期动脉硬化评估方面的优越性。

方法

选取于2017年12月至2018年9月就诊于华北理工大学附属医院的住院患者125例：包括ISH患者42例［（56.69±6.16）岁］、SDH患者39例［（55.97±7.23）岁］、正常血压人群44名为健康对照组［（55.18±8.20）岁］。常规二维测量IMT，采用UFPWV检测BS、ES。对上述各组间的BS、ES及IMT值进行单因素方差分析，组内采用LSD-t检验行两两比较。

结果

SDH组IMT、BS值明显高于健康对照组，差异均有统计学意义（t=-2.302、-3.143，P均<0.05）。ISH组IMT、BS、ES值均明显高于健康对照组，差异均有统计学意义（t=-5.024、-3.961、-4.010，P均<0.05）。ISH组BS、ES值均明显高于SDH组，差异均有统计学意义（t=2.596、-2.801，P均<0.05）。

结论

ISH患者较SDH患者血管弹性减低明显，更易发生动脉硬化。在评价早期评价动脉硬化方面，UFPWV较常规二维IMT测量更为敏感。

关键词: 脉搏波传导速度, 收缩期高血压, 动脉硬化, 颈动脉, 动脉弹性
Objective

To quantitatively assess the carotid artery elasticity using ultrafast pulse wave velocity (UFPWV) in patients with ISH and in those with combined systolic and diastolic hypertension (SDH), and to compare the performance of UFPWV versus intima media thickness (IMT) in early evaluation of atherosclerosis.

Methods

Eighty-one patients with hypertension were selected as a study group, including 42 patients with ISH and 39 patients with SDH. Meanwhile, 44 healthy volunteers were selected as a control group. The IMT was measured routinely. UFPWV was used to analyze the ultrafast pulse wave velocity at the beginning (BS) and ending of the systole (ES). All statistical analyses in this study were performed using SPSS statistical software. One-way ANOVA was used to analyze measurement parameters among the above groups, and LSD-t test was used for further comparison.

Results

For IMT, BS, and ES, there were significant differences among the three groups. The IMT and BS in the SDH group were significantly greater than those in the healthy control group (t=-2.302, -3.143, all P<0.05). The IMT, BS, and ES in the ISH group were significantly greater than those in the healthy control group (t=-5.024, -3.961, -4.010, all P<0.05). The BS and ES in the ISH group were significantly greater than those in the SDH group (t=2.596, -2.801, P<0.05).

Conclusions

Patients with ISH have a higher risk of arteriosclerosis compared with patients with SDH. UFPWV is more sensitive than IMT in early evaluation of atherosclerosis.

Key words: PWV, Isolated systolic hypertension, Arteriosclerosis, Carotid, Artery Elasticity
图1 健康人左侧颈总动脉极速脉搏波技术声像图。系统自动测量出颈总动脉前壁脉搏波速度（含收缩起始脉搏波速度5.48 m/s、收缩末期脉搏波速度8.29 m/s，Δ±为检测的稳定性0.41 m/s）
表1 健康对照组与ISH组及SDH组间一般资料比较
组别 例数 男性/女性 年龄（岁，±s） 心率（次/min，±s） 收缩压（mmHg，±s） 舒张压（mmHg，±s） 脉压（mmHg，±s）
健康对照组 44 21/23 55.18±8.20 69.02±10.85 124.38±10.39 76.92±7.31 47.52±8.61
ISH组 42 19/23 56.69±6.16 68.38±11.06 145.74±7.07a 82.67±4.98aC 63.17±8.39aC
SDH组 39 18/21 55.97±7.23 69.15±10.59 147.87±10.12b 94.33±7.33b 53.64±7.02b
统计值 ? χ2=0.06 F=0.46 F=0.06 F=82.86 F=72.26 F=40.86
P值 ? 0.973 0.630 0.942 0.000 0.000 0.000
表2 健康对照组与ISH组及SDH组间BS、ES、IMT参数比较（±s）
组别 例数 BS（m/s） ES（m/s） IMT（mm）
健康对照组 44 6.00±1.08 8.22±1.74 0.74±0.13
ISH组 42 7.70±1.57ac 9.70±1.77ac 0.90±0.18a
SDH组 39 6.79±1.99b 8.62±1.68 0.87±0.23b
F值 ? 12.623 8.308 9.015
P值 ? 0.000 0.000 0.000
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