脉搏波传导速度在假性高血压诊断中的应用

Pulse Wave Velocity for the Diagnosis of Pseudohypertension

目的采用踝臂脉搏波传导速度评价动脉硬化,为假性高血压诊断提供参考。方法冠状动脉造影患者30例,造影结束后同步测量肱动脉内直接血压及间接血压各3次,计算直接血压与间接血压收缩压差值和直接血压与间接血压舒张压差值;并应用动脉硬化检测仪测定双侧踝臂脉搏波传导速度,并获得年龄、疾病、体质指数、血脂参数。根据收缩压差值或舒张压差值是否大于10 mmHg分为假性高血压组和非假性高血压组,对各项变量进行统计学分析。结果两组间的年龄、性别比例、体质指数、吸烟史比例、冠心病比例、糖尿病比例、高脂血症比例、血脂水平相近,差异无统计学意义(P>0.05);脉压(P=0.001)、无创收缩压(P=0.018)、无创血压与直接血压差值差异均有统计学(P<0.05);假性高血压组患者脉搏波传导速度与非假性高血压组患者比较差异具有统计学意义(P=0.029)。根据统计学操作者工作特征曲线得出踝臂脉搏波传导速度>1896.0 cm/s时,预测假性高血压具有最高的敏感度(80.0%)和特异度(73.3%)。Pearson相关分析得出两者的Pearson相关系数为0.431,具有中等相关性。结论根据踝臂脉搏波传导速度的异常可对假性高血压的诊断有参考价值。

Aim To assess the arteriosclerosis by pulse wave velocity （PWV） for providing a reference for the diagnosis of pseudohypertension. Methods Thirty inpatients （male 17, female 13） with coronary angiography whose ages were between 55 - 85 years, were divided into two groups, one group was the pseudohypertension, the other was the comparison. The brachial artery blood pressure and the indirect blood pressure were measured three times simultaneously after coronary angiography, and the difference between direct and indirect systolic and diastolic blood pressure was calculated. The bilateral ankle-brachial PWV（BaPWV） were measured using the atherosclerosis detector and the factors such as ages, diseases, body mass index, blood lipid levels and so on were observed. Results There were no significant difference in age, heart rate, the proportion of smoking, coronary disease, diabetes, and hyperlipidemia between the two groups. But the pulse pressure（P =0. 001 ）, non-invasive blood pressure（P =0. 018） and the difference between non-invasive blood pressure and the direct blood pressure were opposite （ P 〈 0. 05 ）. If there were no difference in the PWV references between the two groups, the PWV measurements of the pseudohypertension were significantly distinct from the non-pseudohypertension （ P = 0. 029）. The BaPWV was the most sensitive （ 80. 8% ） and specific （ 73.3 % ） which was more than 1896.0 cm/s through the ROC curve for prediction of pseudohypertension. Pearson correlation coefficient was 0. 431 between the two which bad a medium relevance by the Pearson correlative analysis. Conclusion BaPWV anomalies can be valuable for diagnosis of pseudohypertension.