极速脉搏波技术评价原发性干燥综合征患者颈动脉弹性

Carotid Artery Elasticity in Patients with Primary Sjogren’s Syndrome Evaluated by Ultrafast Pulse Wave Velocity

目的 探讨极速脉搏波技术检测原发性干燥综合征(pSS)患者的颈动脉脉搏波传导速度(PWV),并分析其影响因素。资料与方法 采用前瞻性研究,选取2021年1—7月于锦州医科大学附属第一医院就诊的无颈动脉内-中膜增厚及斑块形成的pSS患者50例,根据疾病活动度评分分为稳定亚组30例和活动亚组20例,并纳入1 544名志愿者作为对照组。测量颈动脉收缩期开始时脉搏波速度(PWV-BS)和收缩期结束时脉搏波速度(PWV-ES)。分析PWV与临床指标的相关性,采用多元线性逐步回归分析PWV的影响因素。结果 p SS活动亚组的PWV-BS、PWV-ES均高于稳定亚组(t=2.07、 2.14,P<0.05)。Pearson相关分析显示,PWV-BS与年龄、收缩压、舒张压、总胆固醇、C反应蛋白呈正相关(r=0.79、0.64、0.37、0.35、0.66,P<0.05),PWV-ES与年龄、收缩压、舒张压、体重指数、总胆固醇、C反应蛋白呈正相关(r=0.77、0.52、0.31、0.31、0.43、0.58,P<0.05),高密度脂蛋白胆固醇与PWV-BS、PWV-ES均呈负相关(r=0.55、 0.56,P<0.01)。多元线性回归分析显示,年龄、收缩压、高密度脂蛋白胆固醇、C反应蛋白是PWV-BS的影响因素(β=0.42、0.20、 0.23、0.34,P<0.05),年龄、高密度脂蛋白胆固醇、总胆固醇、C反应蛋白是PWV-ES的影响因素(β=0.48、 0.33、0.19、0.23,P<0.05)。结论 极速脉搏波技术检测p SS患者早期颈动脉弹性,PWV可能与动脉硬化危险因素总胆固醇和C反应蛋白相关,为早期发现动脉硬化提供一定参考。

Purpose To detect the carotid pulse wave velocity(PWV) in patients with primary Sjogren’s syndrome(pSS) by ultrafast pulse wave velocity technique, and analyze its influencing factors. Materials and Methods In this prospective study, patients admitted to the First Affiliated Hospital of Jinzhou Medical University from January to July 2021 were selected, a total of 50 patients with pSS without carotid intima-media thickening and plaque formation were selected and divided into stable group(30 cases) and active group(20 cases) according to disease activity score, 1 544 healthy volunteers were taken as control group. PWV at the beginning of systole and the end of systole(PWVBS, PWV-ES) of the carotid artery were measured by ultrafast pulse wave velocity technique. The correlation between PWV and clinical indexes was analyzed, and multiple linear stepwise regression was used to analyze the influencing factors of PWV. Results PWV-BS and PWV-ES of active group were significantly higher than those of stable group(t= 2.07, 2.14, P<0.05). Pearson correlation analysis showed that PWV-BS in pSS group was positively correlated with age, systolic blood pressure, diastolic blood pressure, total cholesterol and c-reactive protein(r=0.79, 0.64, 0.37, 0.35, 0.66, P<0.05), PWV-ES was positively correlated with age, systolic blood pressure, diastolic blood pressure,body mass index, total cholesterol and C-reactive protein(r=0.77, 0.52, 0.31, 0.31, 0.43, 0.58, P<0.05), PWV-BS and PWV-ES were negatively correlated with high-density lipoprotein cholesterol(r= 0.55, 0.56, P<0.01). Multiple linear stepwise regression analysis showed that the influencing factors of PWV-BS were age, systolic blood pressure, high-density lipoprotein cholesterol, C-reactive protein(β=0.42,0.20, 0.23, 0.34, P<0.05);and age, total cholesterol, high-density lipoprotein cholesterol, C-reactive protein were the influencing factors of PWV-ES(β=0.48, 0.19, 0.33, 0.23, P<0.05). Conclusion Ultrafast pulse wave velocity technique can detect the early carotid artery elasticity in patients with pSS, PWV may related with factors of atherosclerosis, which can provide a certain basis for early clinical intervention.