血红蛋白水平及超极速脉搏波技术指标对颈动脉弹性衰退的影响

Effect of hemoglobin level and ultrafast pulse wave velocity technology index on carotid elastic decline

目的探讨不同血红蛋白(Hb)水平及超极速脉搏波(ufPWV)技术指标收缩末期脉搏波速度(PWV-ES)对颈动脉弹性衰退的影响。方法选取2017年1月至2018年12月江苏省中医院/南京中医药大学附属医院收治的188例门诊及住院患者。根据Hb水平将患者分为Q1组(Hb<115 g/L)(n=50)、Q2组(115 g/L≤Hb<130 g/L)(n=45)、Q3组(130 g/L≤Hb<141 g/L)(n=51)、Q4组(Hb≥141 g/L)(n=42)。收集所有患者的临床资料;采用ufPWV技术测定颈动脉弹性,获得颈动脉收缩起始脉搏波速度(PWV-BS)和PWV-ES。通过逐步多因素线性回归分析PWV-ES增快的影响因素。结果4组患者的性别、慢性肾病情况、血尿素氮(BUN)水平、血清肌酐(SCr)水平、血尿酸(BUA)水平、甘油三酯(TG)水平、低密度脂蛋白胆固醇(LDL-C)水平、估计肾小球滤过率(eGFR)、Hb水平、PWV-ES比较,差异均有统计学意义(P<0.05)。由于PWV-ES较PWV-BS能够更好地反映组间差异,故使用PWV-ES作为ufPWV技术代表性颈动脉弹性衰退指标用于后续分析。单因素线性回归分析结果显示,PWV-ES与年龄、Hb水平均呈正相关,而与BUN、SCr、BUA水平均呈负相关(P<0.05)。多因素逐步线性回归分析结果显示,PWV-ES与年龄、Hb水平均呈正相关,年龄增加、Hb水平升高均是PWV-ES增快的独立危险因素(P<0.01)。结论年龄增加、Hb水平升高均是PWV-ES增快的独立危险因素,颈动脉弹性衰退的风险随着年龄的增加、Hb水平的升高而增加。

Objective To investigate effects of different hemoglobin(Hb)levels and ultrafast pulse wave velocity(ufPWV)technology index pulse wave velocity-end of systole(PWV-ES)on the carotid elastic decline.Method A total of 188 outpatient and inpatient from Jiangsu Province Hospital of Chinese Medicine/Affiliated Hospital of Nanjing University of Chinese Medicine from January 2017 to December 2018 were selected.Patients were divided into Q1 group(Hb<115 g/L,n=50),Q2 group(115 g/L≤Hb<130 g/L,n=45),Q3 group(130 g/L≤Hb<141 g/L,n=51)and Q4 group(Hb≥141 g/L,n=42)according to Hb concentration.The carotid elasticity was measured by ufPWV technique to obtain pulse wave velocity-beginning of systole(PWV-BS)and PWV-ES.The influencing factors of PWV-ES were analyzed by stepwise multivariate linear regression.Result There were significant differences in gender,chronic kidney disease,blood urea nitrogen(BUN)level,serum creatinine(SCr)level,blood uric acid(BUA)level,triglyceride(TG)level,low density lipoprotein cholesterol(LDL-C)level,estimated glomerular filtration rate(eGFR),Hb level and PWV-ES among the four groups(P<0.05).Since PWV-ES can better reflect the differences between groups than PWV-BS,PWV-ES was used as a representative carotid elastic decline index of ufPWV technology for subsequent analysis.Univariate linear regression analysis showed that PWV-ES was positively correlated with age and Hb level,but negatively correlated with bun,SCr and BUA levels(P<0.05).Multivariate stepwise linear regression analysis showed that PWV-ES was positively correlated with age and Hb level,and the increase of age and Hb level were independent risk factors for the increase of PWV-ES(P<0.01).Conclusion The increase of age and Hb level are independent risk factors for the acceleration of PWV-ES.The risk of carotid elasticity decline increases with the increase of age and Hb level.