极速脉搏波技术评估冠状动脉病变患者颈部血管弹性功能及其相关影响因素

Evaluation of Carotid Artery Elasticity and Risk Factors for Coronary Artery Disease Using the Ultrafast Pulse Wave Velocity Technique

目的应用极速脉搏波技术(UFPWV)初步探讨冠状动脉病变患者颈动脉弹性功能及其相关影响因素。方法随机选取行冠状动脉造影的患者为研究对象,并根据颈动脉超声检查结果,排除颈动脉内-中膜增厚及颈动脉斑块患者,根据造影结果分为正常对照组、轻度病变组及中重度病变组,应用UFPWV测量颈动脉弹性参数,包括收缩期开始时脉搏波传导速度(PWV_(BS))和收缩末期时脉搏波传导速度(PWV_(ES))。结果 3组PWV_(BS)、PWV_(ES)比较,差异均有统计学意义(P<0.05);轻度病变组及中重度病变组各数值高于正常对照组(P<0.05);中重度病变组各数值高于轻度病变组(P<0.05)。多元逐步回归分析结果显示,收缩压、年龄、血糖、总胆固醇及尿酸为PWV_(BS)和PWV_(ES)的影响因素。计算出PWV_(BS)和PWV_(ES) 95%可信区间,预测正常参考值范围。结论PWVBS及PWVES受动脉硬化易患因素影响。UFPWV可在早期发现颈动脉弹性变化,可间接估测冠状动脉弹性情况,进而可用于预测冠状动脉病变的初步筛查。

Objective To examine carotid artery elasticity and risk factors for coronary artery disease using the ultrafast pulse wave velocity（UFPWV） technique. Methods Patients who underwent coronary angiography（CAG） and carotid artery ultrasound were randomly selected,and those with carotid intima-media thickening and carotid plaque were excluded. Based on the CAG results,subjects were further divided into normal,mild lesion,and moderate-severe lesion groups. The UFPWV technique was used to measure pulse wave velocity at the beginning of systole（PWV（BS）） and pulse wave velocity at the end of systole（PWV（ES））. Results Differences in PWV（BS）and PWV（ES） among the 3 groups were statistically significant（P〈0.05）. Values in the mild lesion group and moderate-severe group were higher than those in the normal group（P0.05）. Values in the moderate-severe lesion group were higher than those in the mild lesion group（P〈0.05）. Multiple stepwise regression analysis showed that systolic blood pressure,age,fasting plasma glucose,total cholesterol,and uric acid were risk factors affecting PWV（BS） and PWV（ES）. Normal reference ranges were predicted by calculating 95% confidence intervals for PWV（BS） and PWV（ES）. Conclusion PWV（BS） and PWV（ES） are affected by factors predisposing individuals to arteriosclerosis. The UFPWV technique can detect carotid artery elasticity changes at an early stage,and can estimate elasticity indirectly. UFPWV can be used for early screening of coronary artery stenosis.