H型高血压患者脉搏波传导速度、踝臂指数在颈动脉粥样硬化中的预测价值

Predictive Value of Pulse Wave Velocity and ABI in Carotid Atherosclerosis in Patients with H-type Hypertension

目的:探讨H型高血压患者肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)、踝臂指数(ankle brachial index,ABI)对颈动脉粥样硬化发生的预测价值。方法:选择2016年8月-2018年12月本院收住确诊的H型高血压患者150例为研究对象,根据颈动脉内膜中层厚度(cIMT)的不同分为正常组47例、增厚组51例及斑块组52例,检测各组生化指标(空腹血糖、同型半胱氨酸、尿素氮、肌酐、尿酸、甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白)及baPWV、ABI并进行组间比较,分析其与颈动脉cIMT的关系及影响颈动脉粥样硬化的危险因素。结果:正常组baPWV均低于增厚组及斑块组,增厚组低于斑块组,而正常组ABI均高于增厚组及斑块组,差异均有统计学意义(P<0.05);cIMT与年龄、病史及baPWV均呈正相关(r=0.476、0.249、0.617,P<0.05),与ABI呈负相关(r=-0.251,P<0.05);多因素Logistic回归分析结果显示:同型半胱氨酸、年龄及baPWV是颈动脉粥样硬化的危险因素(OR=1.082、2.474、1.007,P<0.05)。结论:H型高血压患者年龄、同型半胱氨酸及baPWV均是颈动脉粥样硬化的独立危险因素,加强检测可以更好地预测早期动脉粥样硬化的发生及发展。

Objective:To investigate the predictive value of brachial-ankle pulse wave velocity(baPWV)and ankle-brachial index(ABI)in carotid atherosclerosis in patients with H-type hypertension.Method:A total of 150 patients with H-type hypertension admitted to our hospital from August 2016 to December 2018 were selected as the study objects,according to their carotid intima-media thickness(cIMT),they were divided into the normal group(n=47),hypertrophic group(n=51)and plaque group(n=52).The biochemical indexes(fasting blood sugar,homocysteine,urea nitrogen,creatinine,uric acid,triglycerides,total cholesterol,low density lipoprotein,high density lipoprotein),baPWV and ABI of each group were detected and compared.The relationship between them and carotid cIMT and the risk factors of carotid atherosclerosis were analyzed.Result:The baPWV of the normal group were lower than those of hypertrophic group and plaque group,while the ABI of the normal group were higher than those of hypertrophic group and plaque group(P<0.05).cIMT was positively correlated with age,medical history and baPWV(r=0.476,0.249,0.617,P<0.05),and negatively correlated with ABI(r=-0.251,P<0.05).Multiple Logistic regression analysis showed that homocysteine,age and baPWV were risk factors for carotid atherosclerosis(OR=1.082,2.474,1.007,P<0.05).Conclusion:Age,homocysteine and baPWV are independent risk factors for carotid atherosclerosis in patients with H-type hypertension.Strengthen detection can better predict the occurrence and development of early atherosclerosis.