高频超声观察运动对血管功能的影响

A preliminary study on the effects of exercise on vascular function by high frequency ultrasound

目的评价高频超声观察运动对健康成年人血管功能的影响。方法选取49例健康志愿者,分别于运动基础、运动峰值及恢复期,应用超声射频信号血管僵硬度(QAS)技术获取右侧颈动脉顺应性(CC)、扩张性(DC)、硬度参数(α、β)及脉搏波传播速度(PWV),应用二维斑点追踪(X-strain)技术获取右侧颈动脉内膜环向应变(EN-CS)、外膜环向应变(EP-CS)、内膜环向应变率(EN-CSR)、外膜环向应变率(EP-CSR),分析EN-CS、EP-CS、EN-CSR、EP-CSR与CC、DC、α、β、PWV的相关性。结果在运动基础、运动峰值及恢复期,CC分别为(1.436±0.448)mm2/kPa、(1.041±0.432)mm2/kPa、(1.191±0.467)mm2/kPa,DC分别为(0.040±0.016)1/kPa、(0.031±0.013)1/kPa、(0.034±0.013)1/kPa,CC、DC随时间改变呈先降低后增高的趋势(F=12.99、7.65,P均<0.01);PWV分别为(5.037±0.798)m/s、(5.845±1.165)m/s、(5.683±1.367)m/s,α分别为2.298±0.633、3.303±1.697、3.092±1.533,β分别为4.762±1.284、6.794±2.515、6.158±3.089,PWV、α、β随时间改变呈先增高后降低的趋势(F=9.21、13.24、12.33,P均<0.01)。在运动基础、运动峰值及恢复期,EN-CS分别为(7.825±2.445)%、(9.105±4.234)%、(6.271±2.527)%,EN-CSR分别为(0.831±0.276)s-1、(1.219±0.556)s-1、(0.765±0.282)s-1,EP-CS分别为(6.894±2.465)%、(7.936±3.628)%、(5.489±2.306)%,EP-CSR分别为(0.714±0.247)s-1、(1.019±0.414)s-1、(0.656±0.237)s-1,EN-CS、EN-CSR、EP-CS、EP-CSR随时间改变呈先增高后降低的趋势(F=25.92、43.76、21.22、47.98,P均<0.01)。相关性分析表明:EN-CS、EN-CSR、EP-CS、EP-CSR与PWV、α、β呈正相关(r=0.253~0.494,P均<0.05),与CC、DC呈负相关(r=-0.234^-0.562,P均<0.05)。结论血管功能参数CC、DC、α、β、PWV、EN-CS、EN-CSR、EP-CS、EP-CSR均可从不同角度反映血管功能的变化,适当的运动能够改善血管弹性。

[Abstract] Objective To evaluate the effects of high frequency ultrasound in the assessment of vascular function during exercise in healthy subjects. Methods Forty-nine healthy subjects were enrolled in this study. The parameters of vascular function were measured at different stages （rest, exercise peak and recovery）. Compliance coefficient （CC）, distensibility coefficient （DC）, stiffness index a, stiffness index 13 and pulse wave velocity （PWV） were measured by RF-Data technique of ultrasound vascular measurement （quantitative arterial stiffness, QAS）. Endocardium-circumferential strain （EN-CS）, epicardium-circumferential strain （EP-CS）, endocardium-circumferential strain rate （EN-CSR） and epicardium-circumferential strain rate （EP-CSR） were collected by two-dimensional speckle tracking imaging （X-strain）. The correlation between EN-CS, EN-CSR, EP-CS, EP-CSR and CC, DC, stiffness index ct, stiffness index [3 and PWV were analyzed. Results At different stages （rest, exercise peak and recovery）, CC were （1.436± 0.448）, （1.041±0.432） and （1.191±0.467） mm2/kPa DC were （0.040±0.016）, （0.031±0.013） and （0.034±0.013） 1/kPa. CC and DC significantly decreased at exercise peak （F=12.99 and 7.65, both P 〈 0.01）. At different stages （rest, exercise peak and recovery）, PWV were （5.037±0.798）, （5.845±1.165） and （5.683±1.367） m/s, stiffness index a were 2.298 ± 0.633, 3.303 ± 1.697 and 3.092 ± 1.533, stiffness index 13 were 4.762 ± 1.284, 6.794 ± 2.515 and 6.158± 3.089. PWV, stiffness index a and stiffness index 13 significantly increased at exercise peak （F=9.21, 13.24 and 12.33, all P 〈 0.01）. At different stages （rest, exercise peak and recovery）, EN-CS were （7.8254-2.445）%, （9.1054-4.234）% and （6.271 4±2.527）%, EN-CSR were （0.8314±0.276）, （1.2194±0.556） and （0.7654±0.282） s^-1, EP-CS were （6.894±2.465）%, （7.9364±3.628）% and （5.4894±2.306）%, EP-CSR were （0.7144±0.247）, （1.019±0.414） and （0.6564±0.237） s^-1. EN-CS, EN-CSR, EP-CS and EP-CSR significantly increased at exercise peak （F=25.92, 43.76, 21.22 and 47.98, all P 〈 0.01）. EN-CS, EN-CSR, EP-CS and EP-CSR were positively correlated with PWV, stiffness index a and stiffiaess index 13 （r：from 0.253 to 0.494, all P〈0.05）, negatively correlated with CC and DC （r：from -0.234 to -0.562, all P〈0.05）. Conclusions CC, DC, stiffness index a, stiffness index 13, PWV, EN-CS, EN-CSR, EP-CS and EP-CSR all can reflect the changes of vascular function during exercise. Properly exercise has positively direct effect on vascular elasticity.