超声WI技术评价维持性血液透析患者颈总动脉早期粥样硬化及心血管整体功能

Evaluation of early atherosclerosis and integrated cardiovascular function of common carotid using ultrasonic wave intensity in maintenance dialysis patients

目的采用超声瞬时波强(WI)技术评价维持性血液透析(MHD)患者颈动脉早期粥样硬化及心血管整体功能。方法选取30例MHD患者(MHD组)及30名健康人群(对照组),分别行颈总动脉无创WI检查及常规超声检查,并将WI检测指标与血管回声跟踪(ET)指标及常规超声检测参数进行组间比较和参数间相关性分析。结果两组组内比较:双侧颈总动脉WI各项指标差异无统计学意义(P>0.05)。两组组间比较:MHD组瞬时加速度波强(w1)、瞬时减速度波强(w2)、w1到w2的时间(w1-w2)、动脉弹性参数—颈动脉僵硬度(β)、血管的压力-应变弹性系数(EP)、单点脉搏波传导速度(PWVβ)、WI脉搏波传导速度(PWVwi)均较对照组明显升高(P<0.01);MHD组的颈动脉顺应性(AC)较对照组明显减低(P<0.01)。两组组内相关性分析:W1值与SBP水平呈正相关(r=0.32,P<0.01);W1值与PWVβ呈正相关(r=0.31,P<0.05)。w1-w2与心率呈负相关(r=-0.45,P<0.01)。结论 WI技术有可能在常规超声所测量的颈动脉内中膜厚度(IMT)的基础上能更为全面地量化评价MHD患者颈总动脉动脉硬化导致的动脉功能变化,并能进一步评价其左心室-颈总动脉血流动力学状态,从而更为全面地反映MHD患者心血管系统整体功能。

Objective To evaluate functional changes of carotid artery athrosclerosis and the integrated cardiovas-cular function in patients with maintenance hemodialysis （MHD） at early stage using ultrasonic wave intensity technology. Methods Thirty patients with MHD were enrolled while matched with thirty healthy people. Noninvasive wave intensity （WI）, e-tracking and rountine ultrasound examinations were performed, and the comparison and correlation analysis between and within two groups of the WI indices and the echo-tracking （ET） indices and the conventional ultrasonic parameters were carried out separately. Results There were no statistically significant difference of WI parameters of bilateral carotid artery both in the MHD group and in the control group（P〉0. 05） separately. In the MHD group ,W1, W2, W1-W2, β, EP, PWVβ and PWVwi were significantly higher than those of control group（P〈0.01）. However in the MHD group, AC was significantly lower than that of control group（P〈0.01）. W1 and SBP had a notable positive correlation（r=0.32,P〈0.01）. W1 was also related with PWVβ （r=0.32,P〈0.05）. The relativity about w1-w2 and the heart rates was negative （r=-0.45,P〈0.0l）. Conclusion In patients with MHD, the changes of carotid elasticity function could be demonstrated with WI technology based on conventional ultrasonic parameter, such as intima-media thickness （IMT）. WI technology could also be used to analyze the integrated hemodynamics changes of the left ventricle and the carotid artery,and evaluate the interactive function of the cardiovascular system.