脉搏波速度技术对原发性高血压患者颈动脉弹性功能的初步探讨

摘要

Objective To evaluate the stability and repeatability of pulse wave velocity (PWV), and study the correlation between the arterial stiffness and hypertension using PWV. Methods Seventy two cases of hypertensive patients ( 31 males and 41 females, average age 62.76±12.17 years) were included in this study. Based on the level of blood pressure, 72 hypertensive patients were divided into three subgroups. For comparative study, 26 cases of non⁃hypertensive subjects were enrolled as normal control group including 10 males and 16 females (average age 59.65±8.12 years). Carotid intima⁃media thickness (IMT) and carotid PWV value ( BS, ES) were measured by two doctors separately. The repeatability of IMT, BS and ES value were evaluated using Bland⁃Altman plot. The difference of quantitative parameters ( IMT, BS, ES ) were studied both in between⁃group and the inter⁃group. Results ① There was high repeatability of IMT, BS, ES. ②Relative to IMT, there was significant difference of ES both in between⁃group and inter⁃group. Conclusion PWV measurement was reproducible method to determine arterial stiffness. PWV can be more sen⁃sitive to display the correlation between the arterial stiffness and hypertension.%目的：评价脉搏波速度（ PWV）这一技术的稳定性和可重复性，研究颈动脉弹性和血压之间的相关性。方法收集高血压72例，男31例，女41例，年龄17～85（62．76±12．17）岁。依据血压水平将入组的高血压患者分为三个亚组（1、2、3级组）。同时纳入26例非高血压受检者作为对照组，男10例，女16例，年龄41～76（59．65±8．12）岁。两位医生分别测得颈动脉内中膜厚度（ IMT）、颈动脉PWV数值收缩期开始[ PWV（ BS）]、收缩期结束[ PWV（ ES）]，评价IMT、BS、ES数值的可重复性，同时比较定量参数（ IMT、BS、ES）在组间（高血压组和对照组）及组内（高血压三个亚组）的差异性。结果①IMT、BS、ES数值的可重复性高。②对照组与高血压组之间比较，三个变量（ IMT、BS、ES）均存在组间统计学差异。高血压组组内（三个亚组间）比较：IMT，2级组与3级组无统计学意义；BS，1级组与2级组之间、2级组与3级组无统计学意义；ES，三个亚组间均有统计学意义（ P＜0．05）。结论 PWV技术可重复性高，相对IMT，PWV能更敏感显示血管弹性和血压之间的相关性。