宽脉压分层与颈动脉内膜中层厚度的关系

Relationship of wide pulse pressure stratification and carotid intima media thickness

目的探讨宽脉压分层对动脉粥样硬化程度的评估价值。方法对360例受检者采用标准血压测量和颈动脉超声探测,并将所得的脉压差(PP)和脉压指数(PPI)按递增逐级分层,比较各层次之间的颈动脉内膜中层厚度(IMT)及斑块发生率。结果以≥60 mm Hg(1 mm Hg=0.133 k Pa)为宽PP,每10 mm Hg分为1层,5层的IMT分别为0.82±0.23、1.10±0.25、1.15±0.27、1.20±0.24、1.23±0.19;5层的斑块发生率分别为12.88%、33.67%、53.13%、82.61%、91.67%。以≥0.4为宽PPI,每0.1分为一层,5层的IMT分别为0.68±0.14、0.94±0.23、1.04±0.24、1.20±0.26、1.26±0.25,5层的斑块发生率分别为13.42%、35.05%、53.85%、90.91%、93.75%。IMT及斑块发生率随宽PP及宽PPI的层次升高而升高,不同宽PP和宽PPI分层组之间,IMT及斑块发生率比较差异有统计学意义(P均<0.05)。结论宽脉压分层能够由表及里,由低到高地反映颈动脉粥样硬化情况,是动脉硬化性疾病的筛查和评估的简易方法之一。

Objective To explore the evaluation value of wide pulse pressure stratification on the degree of atherosclerosis. Methods Standard blood pressure measurement and carotid ultrasound detection were adopted to check 360 subjects, and the pulse pressure difference（PP） and pulse pressure index（PPI） were gradually stratified according to progressive increase ,then the carotid intirna media thickness（IMT） of various layers and plaque incidences were com- pared.Results Pulse pressure 1〉 60 mmHg（1 mmHg= 0.133 kPa） was regarded as wide PP, and every 10 mmHg was 1 layer,then the IMT of five layers were respectively 0.82 ± 0.23,1.10 ± 0.25,1.15 ± 0.27,1.20 ± 0.24,and 1.23 ± 0.19;The plaque incidence of five layers were respectively 12.88% , 33 .67% , 53.13% ,82.61% ,and 91.67%.Pulse pressure index≥0.4 was regarded as wide PPI,and every 0.l was 1 layer,then the IMT of 5 layers were 0.68 ± 0.14,0.94 ± 0.23,1.04 ± 0.24,1.20 ± 0.26, and 1.26 ± 0.25 respectively ; The plaque incidence of five layers were 13.42%, 35.05%, 53.85%, 90.91%, and 93.75% respectively.IMT and plaque incidence increase with the increase of the PP and PH levels.The comparison of IMT and plaque incidence between stratified groups with different wide PP and wide PPI showed differences of statistical significance （P 〈 0.05）.Conclusion Wide pulse pressure stratification can reflect the degree of carotid atherosclerosis from superficies to interior, from low to high, and it is one of the sim- ple methods of screening and evaluation of atherosclerosis diseases.