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超极速脉搏波技术评估药物控制高血压患者颈动脉弹性衰退危险因素的临床研究
作者:何姗姗1  朱正球1  沈碧潇1  张心怡1  邹冲2  刘福明3  黄辉1 
单位:1. 江苏省中医院, 南京中医药大学附属医院 超声医学科, 江苏 南京 210029;
2. 江苏省中医院, 南京中医药大学附属医院 国家中药临床试验研究中心, 江苏 南京 210029;
3. 江苏省中医院, 南京中医药大学附属医院 心内科, 江苏 南京 210029
关键词:超极速脉搏波 颈动脉弹性 高血压 危险因素 
分类号:R544.1;R445.1
出版年·卷·期(页码):2021·40·第四期(450-456)
摘要:

目的:探讨超极速脉搏波(ufPWV)技术评估药物控制高血压患者颈动脉弹性衰退危险因素的作用。方法:选择2018年12月至2020年9月我院收治的109例药物控制高血压[收缩压(SBP)<140 mmHg、舒张压(DBP)<90 mmHg]患者为血压控制组,男56例,女53例,年龄24~80岁,平均(63.9±12.2)岁;另纳入同期在我院体检的151例血压正常者为健康成人组,男68例,女83例,年龄18~80岁,平均(45.3±16.0)岁。比较两组研究对象年龄、性别、身高、体重、体质指数(BMI)、SBP、DBP,血脂指标包括总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)值,颈动脉内中膜厚度(cIMT)、收缩起始脉搏波速度(PWV-BS)、收缩末期脉搏波速度(PWV-ES)值的差异。以PWV-ES值为因变量,采用Logistic回归分析对血压控制组进行颈动脉粥样硬化风险因素评估。结果:血压控制组与健康成人组比较,年龄、体重、BMI、吸烟史、慢性病史及TG、HDL、LDL、cIMT、PWV-BS、PWV-ES值差异均有统计学意义(P<0.05);且cIMT、PWV-BS及PWV-ES值与年龄呈线性正相关(分别r=0.134,P<0.01;r=0.295,P<0.01;r=0.395,P<0.01)。Logistic回归分析显示PWV-ES值增高可以作为药物控制高血压患者颈动脉弹性衰退的独立风险预测因素(OR=1.595,P<0.01)。结论:PWV-ES值增高是药物控制高血压(SBP<140 mmHg)患者颈动脉弹性衰退的独立危险因素;ufPWV技术可以较稳定地评价早期颈动脉弹性衰退情况。

Objective: To explore the application of ultrafast pulse wave velocity technology in evaluating the risk factors of carotid artery elasticity decline in patients with hypertension controlled by drugs. Methods: One hundred and nine patients with drug-controlled blood pressure(SBP<140 mmHg, DBP<90 mmHg) admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from December 2018 to September 2020 were included as the blood pressure control group, of whom there were 56 males and 53 females, and their age ranged from 18-80 years old with a mean age of (63.9±12.2) years. In the same period,151 non-hypertensives were selected as healthy adult group, which included 68 males and 83 females, and aged from 18 to 80 with an average of (45.31±16.0) years old. The difference in age, gender, height, weight, BMI, SBP, DBP, TC, TG, HDL-C, LDL-C, carotid intima-media thickness(cIMT), pulse wave velocity at the beginning of systole(PWV-BS) and pulse wave velocity at the end of systole(PWV-ES) were compared between the two groups. With PWV-ES as dependent variable, logistic regression analysis was applied to evaluate the risk factors of carotid atherosclerosis in the drug-controlled blood pressure group. Results: Compared with the healthy adult group, the differences of blood pressure control group were of statistical significances in terms of age, weight, BMI, triglycerides, HDL-C, LDL-C, smoking history, chronic disease history, cIMT, PWV-BS, PWV-ES(P<0.05). And the values of cIMT, PWV-BS and PWV-ES were linearly and positively related to age(cIMT: r=134, P<0.01; PWV-BS: r=0.295, P<0.01; PWV-ES: r=0.395, P<0.01). Further application of logistic regression analysis indicated that as an independent risk predictor of carotid artery elasticity decline, increased PWV-ES could be adopted for patients with drug-controlled blood pressure(OR value: 1.595, P<0.01). Conclusion: For patients with drug-controlled blood pressure(systolic blood pressure<140 mmHg),increased PWV-ES is an independent risk factor for carotid artery elasticity decline. PWV technique can more accurately evaluate the early elasticity decline of carotid artery.

参考文献:

[1] HAGHDOOST A A, SADEGHIRAD B, REZAZADEHKERMANI M.Epidemiology and heterogeneity of hypertension in Iran:a systematic review[J]. Arch Iran Med, 2008, 11(4):444-452.
[2] TIMMIS A, TOWNSEND N, GALE C, et al. European Society of Cardiology:cardiovascular disease statistics 2017[J]. Eur Heart J, 2018, 39(7):508-579.
[3] LAMELAS P, DIAZ R, ORLANDINI A, et al. Prevalence, awareness, treatment and control of hypertension in rural and urban communities in Latin American countries[J]. J Hypertens(Los Angel), 2019, 37(9):1813-1821.
[4] 李金根, 马立永, 张立晶.高血压诊治热点研究进展[J]. 医学综述, 2020, 26(23):4666-4671.
[5] ZHU Z Q, CHEN L S, JIANG X Z, et al. Absent atherosclerotic risk factors are associated with carotid stiffening quantified with ultrafast ultrasound imaging[J]. Eur Radiol, 2020, 31(5):3195-3206.
[6] 高慧, 朱正球, 戴萍, 等.超极速脉搏波技术定量评估年龄相关颈动脉弹性衰退的应用价值及平均动脉压对其的影响[J]. 中国临床医学影像杂志, 2020, 31(3):167-170.
[7] 《中国高血压防治指南》修订委员会.中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019, 24(1):24-56.
[8] 吴寸草, 陈琦玲.无创中心动脉脉压与高血压合并动脉粥样硬化性心血管疾病的相关性研究[J]. 中国全科医学, 2021, 24(2):154-158.
[9] 马丽媛, 吴亚哲, 陈伟伟.《中国心血管病报告2018》要点介绍[J]. 中华高血压杂志, 2019, 27(8):712-716.
[10] ZHU Z Q, CHEN L S, WANG H, et al. Carotid stiffness and atherosclerotic risk:non-invasive quantification with ultrafast ultrasound pulse wave velocity[J]. Eur Radiol, 2019, 29(3):1507-1517.
[11] PERALTA C A, ADENEY K L, SHLIPAK M G, et al. Structural and functional vascular alterations and incident hypertension in normotensive adults:the Multi-Ethnic Study of Atherosclerosis[J]. Am J Epidemiol, 2010, 171(1):63-71.
[12] PIEPOLI M F, HOES A W, BROTONS C, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice:the sixth joint task force of the european society of cardiology and other societies on cardiovascular disease prevention in clinical practice[J]. Int J Behav Med, 2017, 24(3):321-419.
[13] MICKAEL T, MATHIAS F.Ultrafast imaging in biomedical ultrasound[J]. IEEE Trans Ultrason Ferroelectr Freq Control, 2014, 61(1):102-119.
[14] MESSAS E, PERNOT M, COUADE M.Arterial wall elasticity:state of the art and future prospects[J]. Diagn Interv Imag, 2013, 94(5):561-569.
[15] MICHEL E S, JACQUES B, PIOTR J, et al. Arterial stiffness, pulse pressure, and cardiovascular disease-is it possible to break the vicious circle[J]. Atheroscler, 2011, 218(2):263-271.
[16] SEO J Y, KIM M K, CHOI B Y L.Elevated brachial-ankle pulse wave velocity is independently associated with microalbuminuria in a rural population[J]. J Korean Med Sci, 2014, 29(7):941-949.

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