Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with type 2 diabetes

The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.

Serum Calcium Level is Associated with Brachial-ankle Pulse Wave Velocity in Middle-aged and Elderly Chinese

Objective To study the relation between serum calcium level and elevated BaPWV in Chinese subjects. Methods The relation between serum calcium level and elevated BaPWV was studied in 9 615 subjects. The mean value of left and right BaPWV was analyzed. BaPWV was defined as high when it was31 752.5 cm/s （the upper quartile） either side. Results The BaPWV and its elevated percentage progressively increased across the quartiles of the serum calcium level （P〈0.05）. The prevalence of elevated BaPWV was significantly higher in subjects of the second, third and highest quartiles than in those of the lowest quartile （26.9%, 28.4%, and 33.2%vs 23.7%, P=0.0116, P=0.0004, and P〈0.0001）. Logistic regression analysis revealed that the risk of elevated BaPWV was 1.32- fold higher in subjects of the highest quartile than in those of the lowest quartile （OR=1.32, 95%CI：1.08-1.60）. Conclusion The elevated serum calcium level is related to an elevated BaPWV and a higher risk of arterial stiffness, independent of conventional risk factors, in middle-aged and elderly Chinese subjects.

Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population

The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity （baPWV）, and the presence of the metabolic syndrome （MS） in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in for the general population, males and females, respectively. our study population was 21.7%, 17.2% and 25.6% With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density lipoprotein （LDL） cholesterol, and the use of anti-hypertensive drug, the stepwise regression analysis showed that baPWV had a significant relationship with components of MS, including systolic blood pressure （P 〈 0.001）, diastolic blood pressure （P 〈 0.001）, glucose （P 〈 0.001）, highdensity lipoprotein （HDL） cholesterol （P = 0.04）, and triglycerides （P 〈 0.001）, but no relationship with waist circumference （P = 0.25）. With an increase in the number of the MS components, baPWV increased significantly both in women and men. This study indicated that the MS is indeed a risk factor for arterial stiffness. Monitoring of baPWV in patients with MS may help in identifying persons at high risk for cardiovascular disease.

Relationship between the Plasma Fibulin-1 Levels,Pulse Wave Velocity,and Vascular Age in Asymptomatic Hyperuricemia

Fibulin-1(FBLN-1),an elastin-associated extracellular matrix protein,has been found in blood and may play a role in the pathophysiological processes leading to cardiovascular disease(CVD).We aimed to investigate the relationship between fibulin-1 levels and the risk of CVD by evaluating vascular age derived from the Framingham Heart Study and brachial-ankle Pulse Wave Velocity(baPWV)in patients with asymptomatic hyperuricemia(AHU).In total,66 patients with AHU and 66 gender-and age-matched healthy individuals were enrolled.The plasma fibulin-1 levels were measured by immunochemistry.Patients with AHU presented significantly higher vascular age[median(interquartile range):54(22)vs.48(14)years,P=0.01]and baPWV[mean±SD:1373±223 vs.1291±177 cm/s,P=0.02]than the healthy subjects;however,no significant difference was observed in the plasma fibulin-1 level between the patients with AHU and healthy subjects[median(interquartile range):4018(3838)vs.3099(3405)ng/mL,P=0.31].A correlation between fibulin-1 levels and baPWV was observed only in patients with AHU(r=0.29,P=0.02);and there was also a suggestively statistically significant correlation between fibulin-1 levels and vascular age(r=0.22,P=0.08).However,these associations were rendered insignificant after adjustments for potential confounders.In healthy subjects,no correlation was observed between fibulin-1 levels and CVD risk.This study reveals that plasma fibulin-1 levels may reflect the CVD risk in patients with AHU,but the relationship is not robust.

Increased brachial-ankle pulse wave velocity is associated with impaired endothelial function in patients with coronary artery disease

Background Pulse wave velocity and flow-mediated vasodilation （FMD） are widely used as noninvasive modalities for evaluating atherosclerosis. However, it is not known whether pulse wave velocity is related to FMD in patients with coronary artery disease （CAD）. Therefore, the present study was designed to investigate the alteration in brachial-ankle pulse wave velocity （baPWV） and endothelial function in CAD patients. Methods Thirty-three patients with CAD and thirty control subjects were recruited for this study, baPWV was measured non-invasively using a VP 1000 automated PWV/ABI analyzer （PWV/ABI, Colin Co. Ltd., Komaki, Japan）. Endothelial function as reflected by FMD in the brachial artery was assessed with a high-resolution ultrasound device. Results baPWV was increased in CAD patients compared with control subjects [（1756.1±253.1） cm/s vs （1495.3±202.3） cm/s, P〈0.01]. FMD was significantly reduced in CAD patients compared with control subjects [（5.2±2.1） % vs （11.1±4.4） %, P〈0.01]. baPWV correlated with FMD （r =-0.68, P〈0.001）. The endothelium-independent vasodilation induced by sublingual nitroglycerin in the brachial artery was similar in the CAD group compared with the control group.Conclusions CAD is associated with increased baPWV and endothelial dysfunction. Increased baPWV parallels diminished endothelial function. Our data therefore suggest that baPWV can be used as a noninvasive surrogate index in clinical evaluation of endothelial function.

Reference values of brachial-ankle pulse wave velocity for Northern Chinese

Background Brachial-ankle pulse wave velocity （baPWV） is a reliable method for measuring arterial elasticity, but the absence of reference value for baPWV has limited its wide use. We conducted an epidemical study in north China to investigate the reference value of baPWV for Chinese people and its influential factors. Methods A total of 974 identified healthy subjects were recruited in this study. The values of baPWV were evaluated noninvasively with an automatic device. Results For healthy population, the mean value of baPWV was higher for male （P 〈0.001）. Multiple regression analysis demonstrated that both age and systolic blood pressure were positively associated with baPWV for male and female （P 〈0.001）. BaPWV value was higher in male than in female in younger group （〈50 years） but not in older group （P〈-0.001）. The upper limits of baPWV were 1394/1264 cm/s, 1435/1361 cm/s, 1552/1433 cm/s, 1597/1609 cm/s and 1798/1915 cm/s for healthy male/female at 10 years interval （age range 20-70 years）. Conclusions Aging is the most important reason of arterial stiffness, but the effect of age on baPWV augmentation is greater for healthy female than their male counterpart. The reference values of baPWV by sex and age are very useful for clinical and preventive medicine.

Can we early diagnose metabolic syndrome using brachial-ankle pulse wave velocity in community population？

Background The prevalence of metabolic syndrome （MetS） increased recently and there was still not a screening index to predict MetS.The aim of this study was to estimate whether brachial-ankle pulse wave velocity （baPVVV）,a novel marker for systemic arterial stiffness,could predict MetS in Chinese community population.Methods A total of 2 191 participants were recruited and underwent medical examination including 1 455 men and 756 women from June 2011 to January 2012.MetS was diagnosed according to the criteria of the International Diabetes Federation （IDF）.Multiple Logistic regressions were conducted to explore the risk factors of MetS.Receiver operating characteristic （ROC） curve was performed to estimate the ideal diagnostic cutoff point of baPWV to predict MetS.Results The mean age was （45.35±8.27） years old.In multiple Logistic regression analysis,the gender,baPWV and smoking status were risk factors to MetS after adjusting age,gender,baPWV,walk time and sleeping time.The prevalence of MetS was 17.48% in 30-year age population in Shanghai.There were significant differences （Х^2=96.46,P 〈0.05） between male and female participants on MetS prevalence.According to the ROC analyses,the ideal cutoff point of baPWV was 1 358.50 cm/s （AUC=60.20%） to predict MetS among male group and 1 350.00 cm/s （AUC=70.90%） among female group.Conclusion BaPWV may be considered as a screening marker to predict MetS in community Chinese population and the diagnostic value of 1 350.00 cm/s was more significant for the female group.

New definition of metabolic dysfunction-associated fatty liver disease with elevated brachial-ankle pulse wave velocity and albuminuria: a prospective cohort study

A new definition of metabolic dysfunction-associated fatty liver disease(MAFLD)has recently been proposed.We aim to examine the associations of MAFLD,particularly its discordance from non-alcoholic fatty liver disease(NAFLD),with the progression of elevated brachial-ankle pulse wave velocity(baPWV)and albuminuria in a community-based study sample in Shanghai,China.After 4.3 years of follow-up,778 participants developed elevated baPWV and 499 developed albuminuria.In comparison with the non-MAFLD group,the multivariable adjusted odds ratio(OR)of MAFLD group for new-onset elevated baPWV was 1.25(95%confidence interval(CI)1.01–1.55)and 1.35(95%CI 1.07–1.70)for albuminuria.Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria(OR 1.77;95%CI 1.07–2.94).Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria.In conclusion,MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index,waist circumference,and hip circumference.Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria,supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.

臂踝动脉脉搏波传导速度与发生恶性肿瘤的关系

目的探讨臂踝动脉脉搏波传导速度(baPWV)与发生恶性肿瘤的关系。方法采用横断面研究方法,研究对象为参加2010至2017年健康体检且同时参加baPWV检测的开滦集团职工(41404例)。按照baPWV水平将观察对象分为3组,分别为baPWV<1400 cm/s、1400 cm/s≤baPWV<1800 cm/s和baPWV≥1800 cm/s。采用多因素Logistic回归模型分析不同baPWV分组与恶性肿瘤的关系。结果观察对象年龄(48.1±12.1)岁,男性占71.9%。baPWV<1400 cm/s、1400 cm/s≤baPWV<1800 cm/s、baPWV≥1800 cm/s组发生恶性肿瘤比例分别为0.58%、0.77%、0.92%。多因素Logistic回归模型分析显示,校正混杂因素:年龄、性别、吸烟、饮酒、体育锻炼、空腹血糖、平均动脉压、腰围、体重指数、总胆固醇和C-反应蛋白,与baPWV<1400 cm/s组比较,1400≤baPWV<1800 cm/s和baPWV≥1800 cm/s组观察对象发生恶性肿瘤的OR(95%CI)值分别为1.17(1.06~1.30)、1.47(1.28~1.70)(P<0.01)。结论动脉硬化与发生恶性肿瘤有关联。

心血管病高危人群臂踝脉搏波速度的临床应用

目的观察心血管病高危人群臂踝脉搏波速度(baPWV)与心血管病危险因素和临床心脑血管事件的相关性。方法连续入选111例心血管病高危患者,进行baPWV、身高、体重、腰围、血压、心率测量,病史采集及血液生化检查。高危人群定义为既往发生过心脑血管事件(冠心病、缺血性脑卒中、短暂性脑缺血发作)或具有两种以上心血管危险因素(年龄≥50岁、吸烟、肥胖、高血压病、糖尿病、高脂血症)的人群。比较高baPWV组(≥1700cm/s)与低baPWV组(<1700cm/s)患者具有危险因素个数和临床心脑血管事件发生情况的差异。结果与低baPWV组相比,高baPWV组心脑血管事件发生率较高(分别为35.3%和60.5%,P<0.01),心血管危险因素数目较多[(3.9±1.2)和(4.4±0.9),P<0.05]。影响baPWV的因素主要为年龄(P<0.001)和收缩压(P<0.01)。结论在心血管病高危人群中,baPWV较高的患者心脑血管事件发生率高,心血管危险因素多。年龄和收缩压是影响baPWV的独立危险因素。

类风湿关节炎患者肱踝脉搏波传导速度及相关危险因素的研究

目的研究类风湿关节炎(rheumatoid arthritis,RA)患者动脉血管僵硬度的情况,探讨其与传统动脉硬化危险因素及疾病相关因素的关系。方法采用动脉硬化测定仪检测43例RA患者(RA组)及同期41名健康体检者(对照组)肱踝脉搏波传导速度(baPWV),了解动脉血管僵硬度,分析两组患者血压、血脂、血糖等传统心血管疾病危险因素的差异,并对RA疾病相关因素如病程、疾病活动指数(DAS28)、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)及抗环瓜氨酸肽抗体(抗CCP)等与baPWV之间的关系进行研究。结果 RA组患者baPWV显著高于健康对照组(P=0.000);baPWV≥1400 cm/s者RA组有24例(55.81%),健康对照组仅3例(7.3%),差异有统计学意义(P=0.0000);RA患者中,baPWV>1400 cm/s者较baPWV<1400 cm/s者年龄更大,有更长的病程,hs-CRP、血压及血脂水平均更高,但baPWV与RF及抗CCP无相关性。结论 RA患者动脉血管僵硬度增高的发生率明显增高。除传统动脉硬化危险因素影响外,RA疾病相关的一些因素也参与其中。

α-硫辛酸对臂踝脉搏波速度变化影响的干预研究

目的观察心血管病高危人群口服抗氧化剂α-硫辛酸(alpha-lipoic acid,ALA)前后臂踝脉搏波速度(baPWV)变化,探讨ALA能否降低心血管危险因素及动脉硬化程度,为心血管病人群提供一级预防理论依据。方法采用随机、双盲、对照、交叉试验设计,在克拉玛依市人民医院体检中心按照研究对象入选和排除条件筛选出健康的20～60岁的汉族研究对象104例,经签署知情同意书后,测量身高、体重、腰围、臀围、血脂4项、baPWV。采用区组设计随机化的方法随机分为2组,分别接受为期8周ALA(1200mg/d)干预和安慰剂对照,洗脱4周后,2组交换再进行8周的干预。整个研究过程中保持双盲的设计。比较2次观察终点时干预组和安慰剂对照组间空腹血糖、空腹胰岛素、甘油三酯、总胆固醇、高密度胆固醇、动脉硬化程度等心血管和2型糖尿病危险因素或者心血管疾病相关早期敏感指标等连续变量平均水平的差别。结果按照意向分析(ITT)策略,104例均进入结果分析。干预组左右两侧baPWV前后差值分别为-2.80±11.6和-3.01±12.7,均低于安慰剂组左右两侧baPWV前后差值(分别0.57±12.71和0.28±12.83),口服ALA左右两侧baPWV差异有统计学意义(P<0.05)。结论口服ALA可降低动脉硬化的程度,对氧化应激引起的心血管疾病有一定的预防作用。

肱踝脉搏波速度测定在心血管病风险评估中的应用

目的探讨肱踝脉搏波速度(baPWV)与心血管病危险因素的相关性,以及在心血管病风险评估中的价值。方法入选309例具有心血管病危险因素的患者,测量baPWV、身高、体质量、腰围、血压,检测血脂、血糖、尿酸、肌酐、血同型半胱氨酸等,收集临床资料,并进行Framingham风险评分(FRS)。比较高baPWV组(≥1 750 cm/s)与低baPWV组(<1 750 cm/s)心血管病危险因素的差异。分析baPWV与心血管危险因素积累和FRS之间的关系。结果两组在年龄、三酰甘油、血糖、尿酸、收缩压、舒张压、脉压、高血压史、糖尿病史、心血管病家族史有统计学差异(均P<0.05),多因素Logistic回归分析显示主要影响因素为年龄(P<0.01)、收缩压(P=0.01)、高血压病(P<0.01)和心血管病家族史(P<0.05)。而且,随着心血管危险因素个数的积累,baPWV水平呈逐渐上升趋势(P<0.01)。随着FRS风险等级的增加,baPWV水平呈上升趋势(P<0.01)。结论 baPWV升高可能预示着心血管病危险因素累积个数增加和(或)心血管病风险升高。年龄、收缩压、高血压病史和心血管病家族史是影响baPWV的主要危险因素。

肥胖少年的臂-踝脉搏波速度与心血管疾病危险因素的关系探讨

目的探讨肥胖少年的臂-踝脉搏波速度(brachial-ankle pulse wave velocity,BaPWV),与诱发心血管疾病发生的血生化指标的相关性。方法在北京市海淀区选取165例14~17岁的肥胖少年,男90例,女75例,测量体重、身高、血压后,计算BMI,采用动脉硬化检测仪测量臂-踝脉搏波速度(BaPWV),同时检测空腹血生化指标。分析BaPWV与肥胖相关指标,以及心血管疾病危险因素中血生化指标的关系。结果过度肥胖组的BaPWV,与总胆固醇(total cholesterol,TC)、低密度胆固醇(low density lipoprotein cholesterol,LDL-C)、三酰甘油(triglyceride,TG)呈正相关关系;与体重、体质指数(body mass index,BMI)、收缩压呈正相关关系。按照BaPWV测量值分组,BaPWV增高组(高于正常范围,>P_(95))的BaPWV,与总胆固醇(TC)、低密度胆固醇(LDL-C)呈正相关关系;与年龄、体重、体重指数(BMI)呈正相关关系。BaPWV增高与暴露于过度肥胖(BMI>P_(50))之间关联强度的比值比OR=2.159,OR的95%可信区间为1.011~4.613。说明过度肥胖会使BaPWV高于正常范围(>P_(95))的危险度增加2.159倍。结论总胆固醇(TC)和低密度胆固醇(LDL-C),与过度肥胖(BMI>P_(50)),以及BaPWV高于正常范围(>P_(95))有正相关性。过度肥胖会使BaPWV高于正常范围(>P_(95))的危险度增加。

超声与动脉硬化仪检测肱-踝动脉脉搏波传导速度的相关性研究

目的通过联合运用多普勒超声探头及脉搏波传感器检测肱-踝动脉段血管的脉搏波传导速度(pulse wave velocity,PWV),并将检测结果与动脉硬化仪检测该动脉段的结果进行相关性分析,探讨联合运用超声多普勒探头与脉搏波传感器检测肱-踝动脉段脉搏波传导速度(brachial ankle pulse wave velocity,baPWV)方法的可行性。方法纳入30例正常人,分别将超声多普勒探头与脉搏波传感器放置于受试者左侧肘部肱动脉及左侧踝部胫后动脉,将受试者左侧肘部肱动脉及左侧踝部胫后动脉间的距离与动脉多普勒血流流速曲线的起点与动脉脉搏波起点间的传播时间相比,得出的比值作为肱-踝动脉段的PWV。并将检测结果与动脉硬化仪检测同组受试者该段动脉脉搏波传导速度的检测结果进行相关性分析。结果将脉搏波传感器放置于肱动脉,多普勒探头放置于胫后动脉时的PWV与动脉硬化仪检测得到的baPWV呈显著正相关(r=0.584,P<0.01)。将多普勒探头放置于肱动脉,脉搏波传感器放置于胫后动脉时的PWV与动脉硬化仪检测得到的baPWV呈显著正相关(r=0.703,P<0.01)。结论联合运用超声多普勒探头与脉搏波传感器检测肱-踝动脉段脉搏波传导速度为脉搏波传导速度的检测提供了一种新的检测方法,具有一定的临床实用价值,值得进一步推广。

基于Photoplethysmography和弹性常数的动脉弹性检测方法

针对目前无创动脉弹性检测存在检测费时,操作不便的问题,研究一种基于光电容积脉搏波描记法(photoplethysmography,简称PPG)和弹性常数评估糖尿病患者动脉弹性的检测方法。依据动脉径向振动的压力波方程和弹簧常数模型推导出评估动脉弹性的弹性常数,研究弹性常数与臂踝脉搏波传播速度(brachial ankle pulse wave velocity,简称baPWV)的相关性。统计分析结果表明,基于PPG和桡动脉搏波的弹性常数具有明显的相关关系(p<0.001,r=0.85)。baPWV和基于PPG的弹性常数具有明显的负相关关系(p<0.001,r=-0.701);多元回归分析同样表示两者明显相关。此外,用t检验研究实验组和对照组之间弹性常数的差异;P<0.05表明两组之间的差异有统计学意义。基于PPG的弹性常数法可以有效区分实验组和对照组的动脉弹性特征,是一种快速、有效的动脉弹性检测方法。

贝那普利降血压对臂踝脉搏波传导速度的影响

目的:探讨贝那普利治疗高血压患者后对臂踝脉搏波传导速度(baPWV)的影响,为延缓动脉粥样硬化的速度提供依据。方法:应用贝那普利(或)和非洛地平缓释片治疗87例高血压患者,服药前、服药4周及服药3个月后测量高血压患者的baPWV、血压和动态血压,用欧姆龙PWV/ABI分析仪测量患者的臂踝脉搏波传导速度(baPWV)。结果:baPWV与年龄、24hSBP、24hSSD、24hDSD有关(P<0.05),与24hDBP无关(P>0.05);服用贝那普利4周后有76%的患者血压达标,血压达标的患者服药4周与服药前的baPWV差值有统计学意义(P<0.05),血压未达标患者服药4周与服药前的baPWV差值无统计学意义(P>0.05)。服药3个月后,所有病人血压均达标,原来血压达标组的baPWV与原来未达标组的baPWV比较,差异有统计学意义(P<0.05),原来血压达标组进一步改善。两组治疗前后baPWV差值均有统计学意义(P<0.05)。结论:baPWV与24h平均收缩压及血压变异性有关。贝那普利降压治疗对臂踝脉搏波传导速度有影响,积极降压治疗有利于改善高血压患者的动脉弹性。持续平稳降血压有利于进一步改善高血压患者的动脉弹性。

动脉波速指标和动脉压力容积指标评估动脉硬化的有效性研究

目的动脉波速指标(AVI)和动脉压力容积指标(API)是由动脉脉搏波速率检测仪(AVE-1500型)经波形解析无创估测的动脉硬化指标,分别指示中心动脉和肱动脉的僵硬度,其临床价值已在国外得到了广泛验证,但在我国尚无相关报道。本文旨在通过研究AVI、API与动脉硬化的独立预测因子年龄和动脉僵硬度经典指标baPWV(肱踝脉搏波传导速度)的相关性,评估其作为动脉僵硬度指标的有效性,从而为该检测方法的临床应用提供初步依据。方法在体检中心随机募集受试者,对每位受试者分别采用动脉脉搏波速率检测仪测量AVI、API以及上臂动脉血压,其后使用动脉硬化测量仪(BP-203RPEⅢ型)测量受试者的双侧baPWV。同时,对所有受试者均记录年龄、性别和血液生化指标等一般临床信息。应用Pearson相关分析探讨AVI、API与年龄及ba PWV的相关性;采用检验研究高血压患者组与年龄、性别匹配的健康组测量结果的差异性。结果共募集140例受试者,包括110例健康成年人(47.4±14.4)岁和30例单纯高血压患者(53.5±10.6)岁。结果显示,健康受试者组,AVI与年龄呈高度线性相关(r=0.706,P=0.000),且与baPWV呈显著线性相关(r=0.599,P=0.000),API与年龄、baPWV亦相关,但相关程度明显低于AVI。30例高血压患者与年龄、性别匹配的30例健康受试者比较,高血压组的AVI、API、baPWV大于健康组,其差异具有统计学意义。结论 AVI在监测由年龄、高血压引起的动脉硬化进展方面与baPWV具有相似的效果,API由于局限于对外周动脉(肱动脉)僵硬度的评估,在健康人群中与年龄的相关性较弱,但在评估心血管疾病患者的动脉弹性状况方面仍有一定价值。

高血压患者与正常人的上下肢脉搏波特征差异分析

目的通过挖掘脉搏波中蕴含的与血压相关的特性,分析高血压患者和正常人上下肢脉搏波的差异,以探索高血压的前兆信息。方法分别选取20位特征明显的高血压患者和正常人作为受试者,采集其上下肢脉搏波信号。将脉搏波信号通过无限冲激响应(infinite impulse response, IIR)二阶低通滤波器去除高频干扰,采用单波判别算法进行基线漂移校正,并用三次样条插值法进行标准化归一化处理后,选取脉搏波时域特征参数(脉搏波特征参数K、收缩期特征参数K;、舒张期特征参数K;、主波宽度)、踝臂指数(ankle brachial index, ABI)和肱踝脉搏波传导速度(brachial ankle pulse wave velocity, baPWV)作为上下肢脉搏波特征参数。最后,用SPSS25.0软件对数据进行t检验、相关性分析和主成分分析。结果高血压组与正常组的肱踝脉搏波特征参数差异具有统计学意义。特征参数的相关性分析结果表明,左侧和右侧的脉搏波特征具有较强的相关性,左侧和右侧的脉搏波测量可相互替代;而上肢和下肢的脉搏波特征相关性较弱,上肢和下肢的脉搏波测量不可相互替代。采用主成分分析法进行特征降维,分析最能表征高血压的特征成分,并筛选出高血压组与正常组的典型脉搏波波形图,验证了两组脉搏波具有明显特征差异。结论脉搏波传导速度、踝臂指数及上下肢脉搏波特征参数K对血压水平估计具有重要意义,可为无创血压监测和预防高血压提供参考。

老年心血管病患者动脉扩张性和心脏结构功能的关系

目的探讨老年心血管病患者动脉扩张性与心脏结构和功能之间的关系。方法患者63例,按高血压有无合并冠心病分为2组(单纯高血压组、高血压合并冠心病组),分别应用脉搏波传导速度自动测量系统和超声心动图,对臂踝脉搏波传导速度(baPWV)和心脏结构、功能进行观察。baPWV作为评价动脉扩张性的指标,主动脉内径(AO)、左心房直径(LAD)、左心室舒张末期直径(LVDD)、左心室后壁厚度(LVPW)作为评价心脏结构的指标,左室射血分数(LVEF)和二尖瓣前叶舒张早期运动速度(EF斜率)分别用来评价心脏的收缩和舒张功能。结果baPWV在高血压合并冠心病组明显高于单纯高血压组〔(1 989±793)cm/s vs(1 532±625)cm/s,P<0.01〕;高血压合并冠心病组AO、LAD和LVPW明显高于单纯高血压组,LVEF较单纯高血压组降低,以上差异有统计学意义;LVDD和EF斜率在两组间无显著性差异。结论高血压合并冠心病组baPWV明显高于单纯高血压组,动脉扩张性的降低造成了收缩压及脉压的进一步升高,进而导致左室肥厚,并最终造成心脏结构和功能的改变。