冷加压试验研究血压及血管反应性对动脉弹性参数的影响

Study on the effects of blood pressure and vasoreactivity on the parameters of arterial elasticity via cold pressor test

目的通过冷加压试验观察血压及血管反应性变化对动脉弹性参数测值的影响。方法应用血管回声跟踪技术（ET）测量冷加压试验中22名健康青年男性右侧颈总动脉的瞬时波强（WI），记录其中的动脉弹性参数：僵硬度（p）、弹性模量（Ep）、顺应性（AC）、膨大指数（AI）、β值推导的脉搏波传导速度（PWVβ）及WI值推导的脉搏波传导速度（PWV_WI），并与静息状态下的测值进行比较分析。结果冷加压试验时，心率轻度加快（P〈0．05），而平均动脉压明显上升（P〈0．05）；动脉弹性参数中Ep、AI、PWVβ和PWV_WI值明显升高（P〈0．05），AC值降低（P〈0．05），而β则无明显变化。结论动脉弹性参数中β值受血压及血管反应性的影响较小，能较客观地评定动脉弹性；而Ep、AC、AI、PWVβ和PWV_WI值则受血压及血管反应性的影响较大，以此评定动脉弹性时需注意排除血压及自身紧张状态的影响。

Objective To investigate the interferences of the variations in the blood pressure and vasoreactivity to the parameters of arterial elasticity via cold pressor test（CPT） in healthy young men. Methods The wave intensities（WI） of the right common carotid artery（RCCA） in twenty-two healthy young men during CPT were measured by echo tracking technique. The parameters of arterial elasticity,including stiffness parameter （β）, pressure-strain etastic modulus （Ep）, arlerial compliance （AC）, augument index （AI）, pulse wave veloctiy β （PWVβ） ,and pulse wave velocity WI（PWV WI） from WI analysis during CPT were recorded and statistically compared with the baseline data. Results During CPT, the heart rates increased slightly （ P 〈 0.05） and the mean arterial pressures increased obviously （ P 〈0.05）;As to the parameters of arterial elasticity, the Ep, AI, PWVβ,and PWVWI increased obviously （ P 〈0.05）, AC decreased （ P 〈0.05）, while the β didn＇t change. Conclusions The β is affected little by the blood pressure and vasoreactivity, and can reflect the actual arterial elastieity;while the Ep, AC, AI, PWVβ, and PWV_WI are affected much by blood pressure and vasoreactivity. When the latter parameters are used to evaluate the arterial elasticity, the interferences of variations in hlood pressure and vasoreactivity must be excluded.