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摘要: 目的:探讨高血压患者外周大动脉弹性功能降低的超声诊断界值。方法:选择初次发现高血压的患者201例,按不同级别分成Ⅱ组(1级高血压,72例)、Ⅲ组(2级高血压,68例)、Ⅳ组(3级高血压,61例),选取同期门诊就诊血压正常者75例作为对照组(Ⅰ组)。应用二维超声联合ET技术检测颈、股动脉的内中膜厚度(IMT)及弹性功能参数(β,Ep,AC,PWVβ),采用ROC曲线分析找出血管弹性功能减低的超声诊断界值。结果:高血压各组颈、股动脉的IMT大于对照组,Ⅳ组颈、股动脉的IMT大于Ⅲ组和Ⅱ组,差异有统计学意义(均P＜0.05)。Ⅰ、Ⅱ、Ⅲ、Ⅳ组颈、股动脉的β、Ep、PWVβ值依次升高,AC值依次降低,差异有统计学意义(均P＜0.05)。颈、股动脉β、Ep、AC、PWVβ值ROC曲线下面积均＞0.7,且均具有较高的灵敏度及特异度。结论:高血压患者的外周大动脉弹性明显减低;β(7.45、7.55)、Ep(95.50、98.50 kPa)、AC(0.84、1.05 mm2/kPa)、PWVβ(6.15、6.15 m/s)可以作为高血压患者颈、股动脉弹性减低的超声诊断界值。Abstract: Objective: To explore the ultrasonic diagnostic boundary value which can evaluate the elasticity decrease of peripheral arteries in patients with hypertension. Method: A total of 201 cases with initial diagnosis of hypertension was divided into three groups (groupⅡ,Ⅲ,Ⅳ) according to the blood pressure level. Seventy-five controls with normal blood pressure were assigned to groupⅠ. Two-dimensional ultrasound and technology of ET were used to measure the intima-media thickness (IMT) and elastic functional parameters (β, Ep, AC, PWVβ) of carotid and femoral artery. ROC was used to find the critical value of elastic function on arteries. Result: The parameters of IMT in hypertension groups were greater than those in groupⅠ, and group Ⅳwas greater than group Ⅲ and groupⅡ (all P＜0.05). Parameters of β, Ep, PWVβ were increased while AC was decreased gradually in [CM(48]groupⅠ, groupⅡ, group Ⅲ and groupⅣ (all P＜0.05). The area of β, Ep, AC, PWVβ under the ROC >0.7 and had high sensitivity and specificity.Conclusion: With the increase of blood pressure the elasticity of peripheral arteries significantly reduce. β(7.45, 7.55),Ep(95.50, 98.50 kPa),AC(0.84, 1.05 mm2/kPa),PWVβ(6.15, 6.15 m/s)can be used critical value of elastic function of carotid and femoral artery.
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Key words:
- hypertension /
- carotid artery /
- femoral artery /
- intima-media thickness /
- elasticity
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[1] 杨光,吴云涛,阮晓兰,等.糖尿病、高血压人群心脑血管事件的发生情况及影响因素[J].中华高血压杂志,2014,22(12):1132-1138.
[2] 魏炜,尹益民,谭峰.血管回声跟踪技术在评价不同透析方式对尿毒症患者股动脉弹性功能影响的应用价值[J].实用医学杂志,2014,30(20):3248-3251.
[3] 李殿秋,王辉,崔婷婷.超声弹性成像技术评价2型糖尿病患者颈动脉和足背动脉血管壁弹性[J].中国实验诊断学,2014,18(10):1667-1669.
[4] 中国高血压防治指南修订委员会.中国高血压防治指南2010[J],中国高血压杂志,2011,19(8):701-743.
[5] XU Y,WANG L,HE J,et al.2010China noncommunicable disease surveillance group.Prevalence and control of diabetes in Chinese adults[J].JAMA,2013,310:948-959.
[6] AHMED M H,BARAKAT S,ALMOBARAK A O.Nonalcoholic fatty liver disease and cardiovascular disease:has the time come for cardiologists to be hepatologists?[J].J Obes,2012,2012:48313.
[7] BARTMAN W,PIERZCHALA K.Clinical determinants of carotid intima-media thickness in patients with diabetes mellitus type 2[J].Neurol Neurochir Pol,2012,46:519-528.
[8] 杨彤,张冬青.老年高血压病患者发生下肢动脉硬化症的相关危险因素分析[J].中国临床研究,2012,25(5):431-433.
[9] 赵文,王如瑛,张桂俊.血管回声追踪技术评价T2DM及并发HUA病人颈动脉弹性功能[J].青岛大学医学院学报,2015,51(2):160-162.
[10] 黄伟俊,陈颖瑜,黄婷.高血压患者颈动脉弹性改变的初步观察及其ROC分析[J].实用医学杂志,2014,30(2):281-283.
[11] HAYASHI S,YAMADA H,BANDO M,et al.Augmentation index not reflect risk of coronay artery disease in elderly patients[J].Circ J,2014,78:1176-1182.
[12] CELIK T,YUKSEL U C,FICI F,et al.Vascular inflammation and aortic stiffness relate to early left ventricular diastolic dysfunction in prehypertension[J].Blood Press,2013,22:94-100.
[13] ZHANG P,GUO R,LI Z,et al.Effect of smoking on common carotid artery wall elasticity evaluated echo tracking technique[J].Heart Vessels,2014,40:643-649.
[14] BRABER T L,PRAKKEN N H,MOSTERD A,et al.Identifying coronary artery disease in asymptomatic middle-aged sportsmen:The ADDITIONAL VALUE OF PULSE WAVE VELocity[J].PLOS One,2015,10:e0131895.
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