应用波强技术初步评价原发性高血压患者血流动力学变化

Preliminary observation of the hemodynamic changes of primary hypertension with wave intensity

目的探讨波强(WI)技术评价原发性高血压患者血流动力学变化的临床应用价值。方法对36例原发性高血压患者和30名年龄匹配的健康成人的颈动脉进行超声扫查,应用WI软件获取WI曲线,测量收缩早期峰值(W1)、收缩晚期峰值(W2)、收缩中期负向区面积(NA)、心电图R波顶点至W1的时间间隔(R-1st)、W1至W2的时间间隔(1st-2nd)及时间标化后的R-1sHtR、1st-2HndR等参数。结果①与正常对照组比较,原发性高血压组W1值升高,差异有统计学意义(P<0.01),两组间W2值、NA值、R-1st、1st-2nd、R-1sHtR、1st-2nHdR差异无统计学意义(P>0.05)。②W1值与脉压、收缩压呈显著正相关(r=0.66和r=0.55,P<0.01),W2值与脉压、收缩压亦呈显著正相关(r=0.62和r=0.44,P<0.01),W1值、W2值与年龄和DBP无相关性(P>0.05)。结论WI技术提供的血流动力学参数为临床综合评价高血压患者的心脏、血管功能及其相互作用提供新方法。

Objective To observe hemodynamic changes in patients with primary hypertension with wave intensity（WI）.Methods Carotid arteries of 36 patients with primary hypertension and 30 age-matched normal controls were examined with imaging technique of WI.The following parameters were measured： the first wave peak in early ejection（W1）,the second wave peak in late ejection（W2）,the negative area during the mid-ejection（NA）,the interval between the R wave of the ECG and the first peak of W1（R-1st）,the interval between the first peak and the second peak（1st-2nd）,the ratio of R-1st and a cardiac cycle time R-1stHR） and the ratio of 1st-2nd,as well as one cardiac cycle time（1st-2ndHR）.Results ①W1 in primary hypertension group increased compared with those of normal controls（P〈0.01）,while no significant difference of W2,NA,R-1st,1st-2nd,R-1stHR,1st-2ndHR was detected（P〉0.05）.②Both W1 and W2 correlated positively with pulse pressure（PP） and systolic blood pressure（SBP）（r=0.66,0.55,P〈0.01;r=0.62,0.44,P〈0.01）.W1,W2 and age,DBP were not related significantly（P〉0.05）.Conclusion The hemodynamic parameters of WI technology provide a new way to evaluate the dynamics of the heart and vascular system and their interaction.