高血压病患者外周大动脉弹性功能变化的ROC曲线分析

ROC analysis of peripheral arterial elasticity in patients with hypertension

目的:探讨高血压患者外周大动脉弹性功能降低的超声诊断界值。方法:选择初次发现高血压的患者201例,按不同级别分成Ⅱ组(1级高血压,72例)、Ⅲ组(2级高血压,68例)、Ⅳ组(3级高血压,61例),选取同期门诊就诊血压正常者75例作为对照组(Ⅰ组)。应用二维超声联合ET技术检测颈、股动脉的内中膜厚度(IMT)及弹性功能参数(β,Ep,AC,PWVβ),采用ROC曲线分析找出血管弹性功能减低的超声诊断界值。结果:高血压各组颈、股动脉的IMT大于对照组,Ⅳ组颈、股动脉的IMT大于Ⅲ组和Ⅱ组,差异有统计学意义(均P<0.05)。Ⅰ、Ⅱ、Ⅲ、Ⅳ组颈、股动脉的β、Ep、PWVβ值依次升高,AC值依次降低,差异有统计学意义(均P<0.05)。颈、股动脉β、Ep、AC、PWVβ值ROC曲线下面积均>0.7,且均具有较高的灵敏度及特异度。结论:高血压患者的外周大动脉弹性明显减低;β(7.45、7.55)、Ep(95.50、98.50kPa)、AC(0.84、1.05 mm2/kPa)、PWVβ(6.15、6.15m/s)可以作为高血压患者颈、股动脉弹性减低的超声诊断界值。

Objective：To explore the ultrasonic diagnostic boundary value which can evaluate the elasticity decrease of peripheral arteries in patients with hypertension.Method：A total of 201 cases with initial diagnosis of hypertension was divided into three groups（groupⅡ,Ⅲ,Ⅳ）according to the blood pressure level.Seventy-five controls with normal blood pressure were assigned to groupⅠ.Two-dimensional ultrasound and technology of ET were used to measure the intima-media thickness（IMT）and elastic functional parameters（β,Ep,AC,PWVβ）of carotid and femoral artery.ROC was used to find the critical value of elastic function on arteries.Result：The parameters of IMT in hypertension groups were greater than those in groupⅠ,and groupⅣwas greater than groupⅢ and groupⅡ（all P〈0.05）.Parameters ofβ,Ep,PWVβwere increased while AC was decreased gradually in groupⅠ,groupⅡ,groupⅢand groupⅣ（all P〈0.0 5）.The area ofβ,Ep,AC,PWVβunder the ROC0.7and had high sensitivity and specificity.Conclusion：With the increase of blood pressure the elasticity of peripheral arteries significantly reduce.β（7.45,7.55）,Ep（95.50,98.50kPa）,AC（0.84,1.05mm～2/kPa）,PWVβ（6.15,6.15m/s）can be used critical value of elastic function of carotid and femoral artery.