老年高血压患者CDFI联合CT诊断IMT值与BPV的相关性分析

Correlation Analysis of IMT and BPV in Elderly Patients with Hypertension Diagnosed by CDFI and CT

目的探究颈动脉彩色多普勒超声(CDFI)联合CT诊断在老年高血压患者颈动脉内膜中层厚度(IMT)与动态血压变异性(BPV)相关性研究中的应用价值。方法回顾性分析2018年2月至2019年10月在我院就诊的72例老年高血压患者的临床及影像学资料,根据IMT值将患者分为正常组(IMT<0.9mm,n=27)、增厚组(0.9mm≤IMT<1.3mm,n=30)和斑块组(IMT≥1.5mm,n=15)。所有患者均接受CDFI和多层螺旋CT血管造影(CTA)检查,比较两组患者的BPV指标,对颈动脉斑块及狭窄程度进行测量,分析IMT值与BPV指标的相关性。结果随着IMT值的增加,患者的24h、日间和夜间平均收缩压(24h SBP、dSBP、nSBP)、平均舒张压(24h DBP、dDBP、nDBP)明显增大(P<0.05),24h、日间和夜间的收缩压变异系数(24h SBPCV、dSBPCV、nSBPCV)、舒张压变异系数(24h DBPCV、dDBPCV、nDBPCV)明显增大(P<0.05),三组患者的24h SBP、dSBP、nSBP、24h DBP、dDBP、nDBP、24h SBPCV、dSBPCV、nSBPCV、24h DBPCV、dDBPCV和nDBPCV比较,差异有统计学意义(P<0.05);72例患者共检出狭窄动脉128条,包括轻度狭窄51条,中度狭窄42条和重度狭窄35条,总体动脉狭窄率为44.44%;患者的IMT值与24h SBPCV、dSBPCV、nSBPCV、24h DBPCV、dDBPCV和nDBPCV等BPV指标均呈明显正相关(P<0.05)。结论老年高血压患者颈动脉狭窄率较高,应用CDFI联合CT检查可明确患者的颈动脉狭窄程度及斑块位置;患者IMT值与BPV的变化呈正相关,控制高血压患者BPV指标的变化,有助于改善患者的颈动脉狭窄情况。

Objective To explore the application value of ca rotid a rtery color Doppler ultrasound(CDFI)combined with CT in a correlation study between carotid artery intima-media thickness(IMT)and ambulatory blood pressure variability(BPV)in elderly patients with hypertension.Methods Clinical and imaging data of 72 elderly patients with hypertension treated in the hospital from February 2018 to October 2019 were retrospectively analyzed.The patients were divided into a normal group(IMT<0.9 mm,n=27),thickening group(0.9 mm≤IMT<1.3 mm,n=30)and plaque group(IMT≥1.5 mm,n=15)according to the IMT.All patients were su bjected to CDR and multi-slice spiral CT angiography(CTA).BPV indexes of the two groups were compared.Carotid plaques and stenosis degree were measured,and the correlation between IMT and BPV indexes was analyzed.Results With the increase of IMT,the patient’s24 h,daytime,and nighttime average systolic blood pressure(24 h SBP,dSBP,nSBP)and average diastolic blood pressure(24 h DBP,dDBP,nDBP)increased significantly(P<0.05).The 24 h,daytime,and nighttime systolic blood pressure va riations(24 h SBPCV,dSBPCV,nSBPCV)and diastolic blood pressure variations(24 h DBPCV,dDBPCV,nDBPCV)increased significantly(P<0.05).Differences in abovementioned indexes among the three groups were all statistically significant(P<0.05).A total of 128 stenotic,arteries were detected in the 72 patients,including 51 mild stenoses,42 moderate stenoses and 35 severe stenoses.The overall arterial stenosis rate was 44.44%.The IMT was significantly positively correlated with BPV indexes such as 24 h SBPCV,dSBPCV,nSBPCV,24 h DBPCV,dDBPCV,and nDBPCV(P<0.05).Conclusion The carotid artery stenosis rate in elderly patients with hypertension is relatively higher.The application of CDFI combined with CT can determine the degree of carotid artery stenosis and plaque location.The IMT of patients is positively correlated with changes in BPV.Controlling changes in BPV indexes in patients with hypertension can help alleviate carotid artery stenosis.