640层容积CT评价原发性高血压患者升主动脉弹性变化的可行性和临床意义

The feasibility and clinical significance of 640-slice volume CT in evaluating the elastic change of ascending aorta in patients with essential hypertension

目的探讨利用640层容积CT评价原发性高血压患者升主动脉弹性特点的可行性。方法选取临床确诊为原发性高血压并拟行冠脉CT血管造影(CTA)检查的患者90例,设定为高血压组,按年龄分为40~<50岁、50~60岁、>60岁3组,同时选取血压正常者60例作为对照组。对原始数据0%~100%每间隔10%RR间期进行数据重建,根据软件生成的左心室收缩-舒张曲线,测量升主动脉兴趣层面管腔在收缩期与舒张期的横截面积,分析比较在不同年龄组高血压组与对照组弹性参数的差异及年龄与动脉弹性的相关性,弹性参数包括动脉扩张度(AD)、顺应性(AC)、僵硬度(β)。结果高血压组的AD、AC值低于对照组,β值明显高于对照组,差异均有统计学意义(P<0.01),年龄与动脉弹性明显相关,随着年龄的升高,两组的AD、AC值呈下降趋势,β呈明显上升趋势,且各年龄组之间弹性差异均有统计学意义(P<0.01)。结论随着年龄增长而降低,高血压患者动脉弹性的降低,预示着高血压是动脉弹性降低的重要因素。640层容积CT作为一种无创的检查方法,评价动脉弹性的可行性较好,有一定的临床价值。

Objective To explore the feasibility of using 640-slice volume CT to evaluate the elasticity of ascending aorta in patients with primary hypertension.Methods 90 patients with primary hypertension and undergoing coronary artery(CTA)were enrolled in the hypertension group,and were divided into three groups,according to the age(40-<50 years old,50-60 years old,>60 years old),and 60 normal blood pressure people were selected as the control group at the same time.Reconstructed the data from 0%to 100%of the original data at intervals of 10%of the RR interval.According to the left ventricular systolic-diastolic curve generated by the software,the vascular systolic and diastolic cross-sectional areas of the ascending aorta were measured.Compared the difference in elastic parameters and arterial elasticity between the hypertension group and the control group in different age groups,elastic parameters included arterial distensibility(AD),arterial compliance(AC),and arterial stiffness(β).Results AD and AC values in the hypertension group were lower than those in the control group,andβvalue was significantly higher than that in the control group(P<0.01).Age was significantly related to arterial elasticity,AD and AC decreased while the age increased,βshowed a significant upward trend,and the differences in elastic parameters among all the age groups were statistically significant(P<0.01).Conclusion With age increasing,arterial elasticity decreases in hypertensive patients,indicating that hypertension is an important factor in the reduction of arterial elasticity.640-slice volume CT is a non-invasive examination,it is feasible to evaluate arterial elasticity,and has clinical value.