超极速脉搏波传导速度技术定量评估临界性高血压成年人颈动脉变化

Ultrafast ultrasound pulse wave velocity technique for quantitative assessment of carotid artery changes in adults with borderline hypertension

目的观察超极速脉搏波传导速度(ufPWV)技术定量评估临界性高血压成年人颈动脉形态及弹性变化的价值。方法纳入330名接受颈动脉超声检查的成年人,根据血压分为正常组(n=159)、临界组(n=43)及高血压组(n=128)。正常组收缩压(SBP)<130 mmHg且舒张压(DBP)<80 mmHg;临界组130 mmHg≤SBP<140 mmHg和/或80 mmHg≤DBP<90 mmHg;高血压组SBP≥140 mmHg或DBP≥90 mmHg或正在服用降压药者。测量并比较组间颈动脉内-中膜厚度(cIMT)、收缩起始脉搏波传导速度(PWV-BS)及收缩末期脉搏波传导速度(PWV-ES),并以cIMT=0.05 cm为临界值进行亚组分析。采用Pearson相关性分析评价各参数与年龄的相关性。结果3组间cIMT、cIMT≥0.05 cm者占比、PWV-BS及PWV-ES差异均有统计学意义(P均<0.05);随血压水平升高,cIMT、cIMT≥0.05 cm比例及PWV-ES均升高(P均<0.05),但仅正常组与临界组间PWV-BS差异有统计学意义(P<0.05)。cIMT≥0.05 cm时,各亚组间PWV-BS差异无统计学意义(P>0.05),高血压亚组PWV-ES高于正常亚组(P<0.05);cIMT<0.05 cm时,临界亚组PWV-BS及PWV-ES均高于正常亚组(P均<0.05),高血压亚组PWV-BS低于临界亚组(P<0.05)而PWV-ES高于正常亚组(P<0.05)。cIMT、PWV-BS及PWV-ES均与年龄成正相关(r=0.64、0.33、0.69,P均<0.01)。结论临界性高血压成年人颈动脉形态及弹性已发生改变,且弹性变化可能早于形态变化。

Objective To observe the value of ultrafast ultrasound pulse wave velocity(ufPWV)technique for quantitatively evaluation on changes of carotid artery morphology and elasticity in adults with borderline hypertension.Methods A total of 330 adults who underwent carotid ultrasound were enrolled and divided into normal group(systolic blood pressure[SBP]<130 mmHg and diastolic blood pressure[DBP]<80 mmHg,n=159),critical group(130 mmHg≤SBP<140 mmHg and/or 80 mmHg≤DBP<90 mmHg,n=43)and hypertension group(SBP≥140 mmHg or DBP≥90 mmHg,or taking antihypertensive medicine,n=128)according to blood pressure.Carotid intima-media thickness(cIMT),pulse wave velocity in beginning of systole(PWV-BS)and pulse wave velocity in end of systole(PWV-ES)were measured and compared among groups.Subgroup analysis was then performed taken cIMT=0.05 cm as the critical value.Pearson correlation analysis was used to evaluate the correlations between parameters and age.Results cIMT,the proportions of cIMT≥0.05 cm,PWV-BS and PWV-ES were all significantly different among 3 groups(all P<0.05).Along with the increase of blood pressure level,cIMT,the proportions of cIMT≥0.05 cm and PWV-ES increased(all P<0.05).However,significant difference of PWV-BS was only detected between normal group and critical group(P<0.05).When cIMT≥0.05 cm,there was no significant difference of PWV-BS among subgroups(P>0.05),and PWV-ES in hypertension subgroup was higher than that in normal subgroup(P<0.05).When cIMT<0.05 cm,PWV-BS and PWV-ES in critical subgroup were higher than those in normal subgroup(both P<0.05).PWV-BS level in hypertension subgroup was lower than that in critical subgroup and higher than that in normal subgroup(both P<0.05).cIMT,PWV-BS and PWV-ES were positively correlated with age(r=0.64,0.33,0.69,all P<0.01).Conclusion Changes of morphology and elasticity of carotid artery occurred in borderline hypertension adults,and elastic changes might be earlier than morphological changes.