血管病变早期检测系统在心血管疾病患者中的应用

Application of early vascular disease detection system in patients with cardiovascular disease

目的：探讨血管病变综合检测系统在冠心病、高血压患者评价外周血管结构和功能中的应用价值。方法：132例受检者入选本研究，其中正常组48例，高血压组42例，冠心病组42例，平均年龄为（55．54±9．59）岁（33—85岁）。所有受检者分别应用超声评价颈动脉粥样硬化程度和横断面弹性，动脉硬化检测系统对大动脉节段僵硬度及下肢动脉阻塞程度进行了评估。结果：冠心病及高血压组患者与正常组比较颈动脉粥样斑块的检出率明显增高（分别为35．7％，16．6％，12．5％，P〈0．05）。冠心病和高血压患者超声测定的动脉横断面指标压力应变系数（Ep）及僵硬系数（β）增高，动脉顺应性（AC）降低。冠心病组和高血压组Ep明显高于正常组[分别为（163．96±73．90）kPa比（114．77±35．03）kPa，P〈0．00；（143．75±64．33）kPa比（114．77±35．03）kPa，P〈0．05]；冠心病组的β值显著高于正常人（11．99±4．50比9．32±2．88，P〈0．01）。高血压组AC与正常组比较有显著差异[（0．64±0．21）mm^2／kPa比（0．73±0．27）mm^2／kPa，P〈0．05]。反映动脉节段僵硬度的指标颈动脉-股动脉脉搏波速度（C—FPWV）和肱踝脉搏波传导速度（BaPWV）在冠心病组显著升高[分别为（11．72±2．54）m／a，（1601．45±267．20）cm／s，均为P〈0．05]；反映下肢动脉阻塞程度的踝臂指数（ABI）在冠心病组患者较高血压组和正常组明显降低（分别为1．09±0．14，1．14±0．06，1．15±0．07，P〈0．05）。结论：冠心病、高血压患者外周动脉结构和功能均发生显著病变，应用血管病变早期检测系统无创评价动脉功能和结构的早期变化有利于对血管病变进行综合评价及预后危险评估。外周动脉弹性和阻塞程度检测对筛查冠心病患者有益。

Objective： To evaluate clinical value of early vascular disease detection system in patients with hypertension and coronary heart disease. Methods： 132 subjects were included in our study, 48 normal subjects,42 hypertensive patients,42 coronary heart disease patients,the mean age was 55.54±9.59 years （33 285 years old）. The change of artery structure and function were evaluated by ultrasound and arteriosclerosis examine system in all subjects. Results： Carotid plaque were more common in coronary heart disease and hypertension group than that of in normal group（35.7%, 16.6%, 12.5%, respectively, P 〈 0.05 ）. Ep and β were higher in patients with hypertension group and coronary heart disease group than that of in normal subjects, and AC was lower in patients with hypertension group and coronary heart disease group. Ep was significantly higher in patients with hypertension and coronary heart disease than that of normal subjects[ （ 163.96±73.90） kPa vs （114.77 ± 35.03） kPa,P 〈0.01;（143.75±64.33） kPa vs （114.77 ± 35.03） kPa,P 〈 0.05, respectively]. β was significantly higher in patients coronary heart disease than that of normal subjects（ 11.99 ± 4.50 vs 9.32±2.88 ,P 〈0.01 ）. AC was significantly lower in patients with hypertension group than that of normal subjects[ （0.64 ± 0.21 ） mm^ 2/kPa vs （0.73 ± 0.27 ） mm^2/kPa, P 〈 0.05 ]. Carotid - femoral pulse wave velocity （ C - FPWV） and brachial - ankle pulse wave velocity（BaPWV） were higher in patients with coronary artery disease [ （11.72 ± 2.54） m/s, （ 1601.45 ± 267.20） cm/s, P 〈0.05 ] ;ankle- brachial index（ABI） were lower in coronary artery disease group than that of in hypertension and normal groups （ 1.09 ± 0. 14,1.14 ± 0.06,1.15 ± 0.07, respectively, P 〈 0.05 ） . Conclusions： The early change of the artery function and structure can be estimated conveniently, quickly and non - invasively by ultrasound and other techniques. Early vascular disease detection system could be useful for vascular disease prevention and prognosis evaluation in patients with cardiovascular risk.