高血压病患者颈-股动脉和颈-桡动脉脉搏波速度改变及其影响因素

The changes and impact factors of carotid-femoral and carotid-radial pulse wave velocity in patients with essential hypertension

目的探讨不同年龄和血压水平的高血压病患者颈-股动脉和颈-桡动脉脉搏波速度的改变及其影响因素.方法应用脉搏波速度(pulse wave velocity,PWV)自动测量系统测定颈-股动脉PWV(CFPWV)和颈-桡动脉PWV(CRPWV)分别作为反映中央弹性大动脉和外周中等肌性动脉弹性功能的指标,对517例高血压患者[其中男272例,女245例,年龄17～82岁,平均(52.0±13.0)岁]和118例健康人[其中男52例,女66例,年龄19～82岁,平均(54.2±13.8)岁]进行PWV检测.结果健康人和高血压病患者颈-股动脉PWV均随年龄增大而增加(P<0.001),而颈-桡动脉PWV 无此变化趋势;颈-股动脉PWV和颈-桡动脉PWV均随血压水平升高而增高(P<0.001).多元逐步回归显示,年龄和收缩压是影响颈-股动脉PWV的独立因素;舒张压是影响颈-桡动脉PWV的独立因素(各标准化回归系数P<0.001).结论年龄和血压组分对高血压患者中央弹性大动脉和外周中等肌性动脉弹性功能的影响不同.对大动脉弹性功能改变的检测较外周中等动脉有更重要的临床价值.

Objective To analyze the changes of carotid-femoral and carotid-radial pulse wave velocity in patients with essential hypertension, and effects of age and levels blood pressure levels on these changes. Methods Automatic pulse wave velocity （PWV） measuring system was applied to examine carotid-femoral PWV （CFPWV） and carotid-radial PWV （CRPWV） as the parameters reflecting central elastic large arterial and peripheral muscular medium-sized arterial elasticity respectively. 517 hypertensive patients aged 17 -82 years （272 males and 245 females, mean age 52.0 ± 13.0 years） and 118 healthy subjects aged 19 -82 years （52 males and 66 females, mean age 54. 2 ± 13.8 years） were recruited in the study. Results CFPWV increased with age in both groups （P 〈 0. 001 ）, whereas CRPWV did not change significantly. CFPWV and CRPWV both increased with blood pressure. A stepwise multiple regression analysis demonstrated that age and systolic blood pressure were positively related to CFPWV independently, while diastolic blood pressure was significantly associated with CRPWV. Conclusions Age and components of blood pressure exert different effects on elasticity of central elastic large artery and peripheral muscular medium-sized artery. Examining the change of large arterial elasticity has important clinical value in hypertensive patients.