高血压患者不同部位脉搏波速度和反射波增强指数的变化及相关因素

Changes and related factors of pulse wave velocity on different sites of the arterial system and augmentation index in patients with essential hypertension

目的:研究高血压患者颈-股动脉脉搏波传导速度(CFPWV)、颈-桡动脉脉搏波传导速度(CRP-WV)、颈-踝动脉脉搏波传导速度(CAPWV)和反射波增强指数(AI)的变化及相关因素。方法:选取高血压患者237例(高血压组)和与其性别、年龄相匹配的健康者253名(对照组),采用自动脉搏波传导速度(PWV)分析仪测定不同部位PWV,采用桡动脉压力波分析仪测定AI,并检测空腹血糖、血脂、尿酸等血液生化指标。结果:与对照组比较,高血压组的CFPWV、CRPWV、CAPWV均显著增加(均P<0.01),而AI无明显变化(P=0.194)。多元逐步回归分析显示,年龄[β(标准化系数)=0.324,P<0.01]、收缩压(β=0.284,P<0.01)和性别(β=-0.126,P<0.05)是CFPWV的独立相关因素(R2=0.230);性别(β=-0.353,P<0.01)和舒张压(β=0.175,P<0.01)是CRPWV的独立相关因素(R2=0.167);收缩压(β=0.222,P<0.01)、年龄(β=0.174,P<0.01)和性别(β=-0.108,P<0.05)是CAPWV的独立相关因素(R2=0.105);身高(β=-0.399,P<0.01)、心率(β=-0.352,P<0.01)和收缩压(β=0.140,P<0.01)是AI的独立相关因素(R2=0.290)。结论:高血压患者各部位PWV显著增加,CFPWV和CAPWV主要相关因素相同(年龄、收缩压和性别),但强度略有不同;CRPWV的主要影响因素是性别和舒张压。AI无明显变化,可能不是反映动脉僵硬的敏感、可靠指标。

Objective：To study the changes and impact factors of pulse wave velocity（PWV） on different sites of the arterial system and augmentation index（AI） in patients with essential hypertension（EH）.Method：Two hundred and thirty-seven patients with EH（EH group） and 253 healthy subjects（control group） were recruited.Carotid-femoral pulse wave velocity（CFPWV）,carotid-radial pulse wave velocity（CRPWV） and carotid-ankle pulse wave velocity（CAPWV） were measured using Complior system.System pulse wave analysis at the right radial artery was performed by using SphygmoCor device.AI was calculated by using software of the device.The fasting glucose,lipid,uric acid and other biochemical parameters were also measured.Result：CFPWV,CRPWV and CAPWV were significantly higher in EH group compared with control group（all P0.01）.There was no significant difference in AI between the two groups.A stepwise multiple regressive analysis demonstrated that age [β（standardized coefficient）=0.324,P0.01],systolic blood pressure（β=0.284,P0.01） and sex（β=-0.126,P0.05） were predisposed factors for CFPWV（R2=0.230）.Sex（β=-0.353,P0.01） and diastolic blood pressure（β=0.175,P0.01） were independent determine factors for CRPWV（R2=0.167）,while systolic blood pressure（β=0.222,P0.01）,age（β=0.174,P0.01） and sex（β=-0.108,P0.05） were predictive factors for CAPWV（R2=0.105）.Height（β=-0.399,P0.01）,heart rate（β=-0.352,P0.01） and systolic blood pressure（β=0.140,P0.01） were independent determine factors for AI（R2=0.290）.Conclusion：PWVs on different sites of the arterial system are significantly higher in patients with essential hypertension.Age,blood pressure and sex are independent influencing factors.AI may not be a suitable indicator of arterial stiffness.