极速脉搏波技术在系统性红斑狼疮患者颈动脉弹性功能检测中的应用价值

Application value of ultrafast pulse wave velocity in carotid artery elastic function detection in patients with systemic lupus erythematosus

目的应用极速脉搏波技术检测系统性红斑狼疮(SLE)患者颈动脉的弹性功能,探究其在临床治疗上的应用价值。方法选取2020年10月—2021年4月就诊于蚌埠医学院第一附属医院的93例SLE患者作为实验组,根据临床症状分为:单纯SLE组(B组,共45例)、SLE累及多个系统组(C组,共48例),同期选取20名健康成年人作为对照组(A组)。采用极速脉搏波技术测量所有入组患者颈总动脉内中膜厚度(IMT)、收缩期开始时的脉搏波传导速度(PWVBS)和收缩期结束时的脉搏波传导速度(PWVES),并统计结果进行比较分析,采用Spearman相关性分析研究IMT、PWVBS及PWVES与SLE不同临床分型的相关性,最后绘制ROC曲线评价诊断效能。结果IMT水平比较:A组低于C组,差异有统计学意义(P<0.05),其他组间比较差异均无统计学意义(均P>0.05);PWVBS水平比较:A组<B组<C组,差异有统计学意义(F=10.068,P<0.001);PWVES水平比较:A组<B组<C组,差异有统计学意义(F=27.505,P<0.001);ITM、PWVBS、PWVES水平与不同SLE临床分型均呈正相关关系(r=0.240、0.442、0.394,均P<0.05);PWVBS、PWVES诊断SLE患者颈动脉硬化的ROC曲线下面积分别为0.794(95%CI:0.694~0.894)、0.960(95%CI:0.919~1.000)。结论SLE患者较健康成年人颈动脉弹性降低,并随疾病进展其程度更显著。极速脉搏波技术能快速测量SLE患者颈动脉IMT、PWVBS及PWVES水平,作为血管弹性相关参数指标,其结果客观,值得在临床中广泛应用。

Objective The elastic function of carotid artery in patients with systemic lupus erythematosus(SLE)was measured by ultrafast pulse wave velocity to explore its clinical application value.Methods A total of 93 patients with SLE who visited the First Affiliated Hospital of Bengbu Medical College from October 2020 to April 2021 were selected as the experimental group.According to the clinical symptoms,they were divided into SLE alone(45 cases,group B)and SLE involving multiple systems(48 cases,group C).A total of 20 healthy adults were selected as the control group(group A).Ultrafast pulse wave velocity(UFPWV)was used to quantitatively measure intima-media thickness(IMT),pulse wave velocity at the beginning of systole(PWVBS)and pulse wave velocity at the end of systole(PWVES)of the common carotid artery in all patients.The statistical results were compared and analysed.Spearman correlation analysis was used to analyse the correlation between IMT,PWVBS,PWVES and different clinical types of SLE.Finally,the ROC curve was drawn to evaluate the diagnostic efficiency.Results In terms of IMT level,group A was lower than group C,and the difference was statistically significant(P<0.05);no significant difference was found amongst other groups(P>0.05).In terms of PWVBS level,group A was lower than group B and group B was lower than group C;the difference was statistically significant(F=10.068,P<0.001).In terms of PWVES level,group A was lower than group B and group B was lower than group C;the difference was statistically significant(F=27.505,P<0.001).The levels of ITM,PWVBS and PWVES were positively correlated with different clinical types of SLE(r=0.240,0.442,0.394,all P<0.05).The areas under the ROC curve of PWVBS and PWVES were 0.794(95%CI:0.694-0.894)and 0.960(95%CI:0.919-1.000),respectively.Conclusion Carotid artery elasticity is lower in patients with SLE than in healthy adults,and its degree is more significant as the disease progresses.UFPWV can quickly measure the levels of IMT,PWVBS and PWVES in the carotid artery of patients with SLE.As a parameter index related to vascular elasticity,the results are objective and worthy of wide application in clinical practice.