高血压患者脉搏波传导速度与动脉-心脏结构的相关性研究

Relationship between pulse wave velocity and artery-cardiac structure in hypertension patients

目的探讨臂踝脉搏波传导速度(baPWV)与心脏结构的关系。方法对2009年4月～2010年6月高血压科住院患者临床资料进行回顾性分析,其中578例患者baPWV检查及其他临床资料完善。采用德国Philips IE33型彩色多普勒超声心动图检查仪,探头S5-1,频率2.5 MHz。通过二维引导的M-模式进行测量记录左心室结构。结果在578例患者中,没有调整其他心血管危险因素时,baPWV与年龄、性别、糖尿病程、收缩压、脉压、空腹血糖、餐后2 h血糖、总胆固醇、高密度脂蛋白胆固醇、左室后壁厚度呈正相关。与舒张压、左室舒张末内径、E/A呈显著负相关。但在调整年龄和收缩压之后,baPWV与年龄(P=0.000)、收缩压(P=0.003)、脉压(0.000)呈正相关。而与左室后壁厚度(P=0.083)、左室舒张末内径(P=0.136)、E/A(P=0.191)、主动脉内径(AoD)无明显相关(r=0.796)。结论血管和心脏结构之间存在年龄、血压相关的动脉粥样硬化性动脉–心脏密切相互作用,但AoD、室间隔厚度、左室舒末内径、E/A和舒张压(DBP)的变化早于baPWV与动脉粥样硬化无关。

【Objective】 To research the relationship between brachial-ankle pulse wave velocity（baPWV） and cardiac structure.【Methods】 The inpatient clinical data from Hypertension Ward between 2009.4～2010.6 was retrospectively analyzed.In 578 patients,baPWV and other clinical data were well-documented.Philips Mode IE33 color Doppler echocardiography device with probe S5-1 made in Germany was used,with the frequency of 2.5 MHz.The measurements were obtained from two-dimensional-guided M-mode,recording the left ventricular structure.【Results】 In the 578 patients,when without adjustment for other cardiovascular risk factors,baPWV was correlated with age,sex,duration of diabetes,systolic blood pressure,pulse pressure,fasting blood glucose,2-hour postprandial blood glucose,total cholesterol,high density lipoprotein cholesterol,left ventricular posterior wall thickness positively,and was significantly correlated with diastolic blood pressure,left ventricular end diastolic diameter,E/A negatively.However,after adjusting for age and systolic blood pressure,baPWV was correlated with age（P =0.000）,systolic blood pressure（P =0.003）,pulse pressure（P =0.000） positively,but not apparently correlated with left ventricular posterior wall thickness（P =0.083）,left ventricular end diastolic diameter（P =0.136）,E/A（P =0.191）,aortic diameter（AoD）（r =0.796）.【Conclusion】 Age,blood pressure-related atherosclerotic close arterial-cardiac interaction exists between the vessels and cardiac structures,but AoD,Interventricular septum thickness,left ventricular end diastolic diameter,E/A,and（Diastolic Blood Pressure,DBP） change in early age independent of atherosclerosis.