上肢脉搏波传导速度与脉图参数关联性研究

Correlation Study on Upper-limb Pulse Wave Conduction Velocity and Pulsogram Parameters

目的探究上肢脉搏波传导速度(ulPWV)特征价值及不同脉搏波传导速度(PWV)与脉图参数的关系。方法同步采集82名健康人上肢不同部位多信号波形,利用Matlab提取传导时间与脉图参数,结合传导距离计算6种ulPWV,观察其分布情况并比较左右侧差异;对不同PWV之间的关系进行双变量相关分析,对不同PWV与脉图参数的关系进行典型相关分析。结果心臂脉搏波速度(hbPWV)、心桡脉搏波速度(hrPWV)与心指脉搏波速度(hfPWV)变异率小,可能是较为稳定的ulPWV指标。健康人ulPWV左右侧差异均无统计学意义,不同ulPWV与对应的动脉血管类型及动脉壁构成特点有关,富含主动脉弹性信息的hbPWV最低,反映肌性中小动脉硬度的臂桡脉搏波速度(brPWV)最高,对应手部末梢循环的桡指脉搏波速度(rfPWV)有其特异性。典型相关分析结果显示,PWV指标与脉图参数的集合变量间相关(R=0.612,P=0.004),hbPWV、臂踝脉搏波传导速度(baPWV)与h3/h1正相关、与h5/h1负相关,hrPWV与h4/h1正相关,且hbPWV对PWV集合变量的权重系数大于baPWV。结论健康人左右侧ulPWV反映的动脉血管硬度相近,且不同ulPWV反映对应血管的生理结构特点。健康人不同PWV与脉图参数相关,主动脉硬度信息有可能从“寸口”桡动脉处获取,两者可从中医脉诊和现代医学2个维度结合用于血管健康状况的评价。

Objective To investigate the characteristic value of upper-limb pulse wave velocity(ulPWV)and the relationship between different pulse wave velocity(PWV)and pulsogram parameters.Methods The multi-signal wave forms were collected simultaneously from different parts of the upper limbs of 82 healthy subjects.The conduction time and pulsogram parameters were extracted using Matlab.The six ulPWVs were calculated by combining the conduction distances,and their distribution was observed and the differences between the left and right limbs were compared.The brivariate correlation analysis was used to different PWV,and canonical correlation analysis was used to different PWV and pulsogram parameters.Results Heart-brachial PWV(hbPWV),heart-radial PWV(hrPWV)and heart-finger PWV(hfPWV)had low variability and may be more stable indicators of ulPWV.The differences between the left and right sides of ulPWV in healthy subjects were not statistically significant.The different ulPWVs were related to the corresponding arterial vascular type and arterial wall composition characteristics.HbPWV,which is rich in aortic elasticity information,was the smallest,while brachial-radial PWV(brPWV),which reflects the stiffness of small and medium-sized muscular arteries,was the largest,and radial-finger PWV(rfPWV),which corresponds to the peripheral circulation of the hand,was specific.The results of the canonical correlation analysis showed that the PWV index was correlated with the pooled variables of the pulsogram parameters(R=0.612,P=0.004),in which hbPWV and baPWV were positively correlated with h3/h1,negatively correlated with h5/h1,and hrPWV was positively correlated with h4/h1.The weight coefficient of hbPWV on the pooled PWV variables was greater than that of baPWV.Conclusion The ulPWV in healthy subjects reflects similar vascular stiffness in the left and right upper limbs,and the different ulPWVs reflect the physiological structural characteristics of the corresponding vessels.There is a correlation between different PWV and pulsogram parameters in healthy subjects,and aortic stiffness can potentially be obtained from the wrist pulse,which allows the vascular health to be evaluated in two dimensions of TCM pulse diagnosis and modern medicine.