通过监测心动周期中颈动脉内径与脉压的比值变化评价血管顺应性

Ratio of Common Carotid Artery Diameter Changes to Pulse Blood Pressure in the Cardiac Cycle Reflects Arterial Compliance

目的:探索更加简易可靠的血管顺应性测量新方法和利用血管顺应性推断动脉血管结构病变的实验依据。方法:利用高频二维超声技术,直接测量87例受检对象的颈动脉内径变化,计算出在逻辑上可能与血管顺应性相关的指标ΔD、A1、A2、A3及A4,并与基于物理学定义推导的经典顺应性计算公式所得值比较。结果:ΔD、A1、A2、A3及A4与血管顺应性均呈正相关,相关性均有显著的统计学意义,P<0.01;与血管顺应性风险因子年龄和脉压呈负相关,P<0.01。按照颈动脉内径变化与脉压(PP)比值,即A3=(Ds-Dd)/PP(单位:mm/mmHg),将研究对象分为高(A3≥0.014),中(A3=0.008-0.014)和低顺应性组(A3<0.008),3组相互之间颈动脉斑块发生率都存在显著差异,P<0.05。结论:①单位压力下血管直径的变化A3,能够有效地反映血管顺应性大小,可以作为一种简单可靠的反映血管顺应性的新指标。②颈动脉血管顺应性与粥样硬化斑块发生率呈负相关,故基于血管顺应性测量可以在一定程度上预测粥样硬化斑块发生风险。

Objective： To develop more simple and reliable ways reflecting the artery compliance and predict the arterial pathological changes based on the compliance.Methods： The carotid artery diameter changes in the cardiac cycle of 87 subjects were measured by two-dimensional high frequency ultrasonic technology.The values of compliance were calculated in light of the formula derived from the definition of compliance.Some parameters such as ΔD,A1,A2,A3 and A4,logically related to the vascular compliance,were additionally calculated.Multiple linear logical regression analysis was applied in the data.Results： ΔD,A1,A2,A3 and A4 were positively correlated with vascular compliance,P0.01,and were negatively correlated with age and the pulse blood pressure,P0.01.Statistical differences of carotid atherosclerotic plaque incidence existed among the high（A3≥0.014）,moderate（A3=0.008-0.014） and low compliance group（A30.008）,P0.05.Conclusion： The artery diameter change per unit blood pressure,A3=（Ds-Dd） / PP mm/mmHg,is a novel surrogate maker reliably reflecting the vascular compliance by which the risk of atherosclerosis can be predicted.