极速脉搏波技术评价阻塞性睡眠呼吸暂停综合征相关性高血压患者颈动脉弹性

Carotid Artery Elasticity in Patients with Obstructive Sleep Apnea Syndrome-Related Hypertension Evaluated by Ultrafast Pulse Wave Velocity Technique

目的应用极速脉搏波(UFPWV)技术评价阻塞性睡眠呼吸暂停综合征(OSAHS)相关性高血压患者的颈动脉弹性。资料与方法将119例颈动脉内-中膜无增厚及斑块形成的OSAHS患者纳入研究组,根据诊室血压诊断标准分为高血压组65例和血压正常组54例;同时选取55例健康体检者纳入对照组。收集研究对象的年龄、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等资料。利用UFPWV技术检测颈总动脉收缩期开始时脉搏波传导速度(PWVBS)及颈总动脉收缩结束时脉搏波传导速度(PWVES),比较各组患者的检测参数。采用多元线性逐步回归法分析影响PWVBS和PWVES的独立因素。结果研究组患者BMI、SBP、DBP、FBG、TG、TC、LDL-C、颈动脉内-中膜厚度(IMT)、PWVBS、PWVES均显著高于对照组,差异有统计学意义(P<0.05)。高血压组患者SBP、DBP、PWVBS、PWVES均高于对照组,差异有统计学意义(P均<0.05),但两组IMT差异无统计学意义(P>0.05)。多元线性逐步回归结果显示:独立影响PWVBS的指标包括SBP(OR=1.13,P=0.012)、BMI(OR=1.58,P=0.037)、HDL-C(OR=0.79,P=0.048);影响PWVES的指标包括SBP(OR=1.11,P=0.023)、BMI(OR=1.48,P=0.000)、DBP(OR=1.21,P=0.004)、TG(OR=1.30、P=0.016)、HDL-C(OR=0.87,P=0.035)。结论OSAHS相关性高血压患者颈动脉弹性参数PWVBS、PWVES明显升高。OSAHS患者伴随血压升高,动脉弹性下降。

Purpose To evaluate the carotid artery elasticity in patients with obstructive sleep apnea syndrome(OSAHS)-related hypertension by using ultrafast pulse wave velocity(UFPWV).Materials and Methods A total of 119 OSAHS patients with no carotid intima-media thickening and plaque formation were selected as the study group,and further divided into OSAHS hypertension group(65 cases)and OSAHS non-hypertensive group(54 cases)based on blood pressure level.55 healthy subjects were selected as the control group.The clinical and biochemical parameters,including age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG)and triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were recorded.Simultaneously,UFPWV was used to measure the pulse wave velocity in beginning of systole(PWVBS)and pulse wave velocity in ending of carotid systole(PWVES).Logistic regression analysis was used to detect the independent factor of PWVBS and PWVES.Results BMI,SBP,DBP,FBG,TG,TC,LDL-C,carotid intima-media thickness(IMT),PWVBS and PWVES of study group were significantly higher than those control group(P<0.05).The SBP,DBP,BS,ES in hypertension group were significantly higher than those in non-hypertensive group(P<0.05),but there was no significant difference in IMT between these two groups(P>0.05).Logistic regression analysis showed that the independent factors of PWVBS were SBP(OR=1.13,P=0.012),BMI(OR=1.58,P=0.037)and HDL-C(OR=0.79,P=0.048);the independent factors of PWVES were(OR=1.11,P=0.023),BMI(OR=1.48,P=0.000),DBP(OR=1.21,P=0.004),TG(OR=1.30,P=0.016)and HDL-C(OR=0.87,P=0.035).Conclusion The carotid elasticity parameters such as PWVBS and PWVES in OSAHS patients with hypertension are significantly increased,indicating carotid elasticity decreases with blood pressure increases.