高血压人群颈动脉超极速脉搏波速度与年龄的相关性研究-现代医学

高血压人群颈动脉超极速脉搏波速度与年龄的相关性研究

单位：1. 江苏省中医院/南京中医药大学附属医院超声医学科, 江苏南京 210029;
2. 江苏省中医院/南京中医药大学附属医院老年科, 江苏南京 210029;
3. 江苏省中医院/南京中医药大学附属医院心血管内科, 江苏南京 210029

关键词：超极速脉搏波年龄高血压内中膜厚度

分类号：R445.1

出版年·卷·期（页码）：2024·52·第六期（831-836）

摘要：

目的： 评估年龄对颈动脉弹性的影响价值，对高血压患者进行超极速脉搏波(ufPWV)检测方法的定量评估。方法： 纳入2018年9月—2022年9月于江苏省中医院体检及入院的159例高血压受试者(实验组)，另将同期体检的253例血压正常者纳入研究为对照组。通过ufPWV检测方法测量收缩开始时(PWV-BS)和收缩结束时(PWV-ES)的脉搏波速度，并测量颈动脉内中膜厚度(cIMT)。所有研究对象被划分为6个不同的年龄段，分别是19~29岁、30~39岁、40~49岁、50~59岁、60~69岁、≥70岁。对比分析各年龄段内高血压患者和血压正常者的PWV-ES值和PWV-BS值。分析实验组和对照组的PWV-BS、PWV-ES值与年龄之间的相关性。结果： 实验组PWV-BS为(6.0±1.7) m/s、PWV-ES为(9.0±2.6) m/s、cIMT为(0.063±0.026) cm, 对照组PWV-BS为(6.1±1.4) m/s、PWV-ES为(7.7±2.4) m/s、cIMT为(0.053±0.010) cm，两组之间分析结果显示PWV-ES和cIMT差异有统计学意义(P<0.001)，PWV-BS的差异无统计学意义(P=0.68)。在被划分的6个不同年龄段内，高血压患者与血压正常者之间比较显示PWV-ES差异有统计学意义的仅为30~39岁、40~49岁、50~59岁3个年龄段(分别P<0.05、P<0.01、P<0.001)。PWV-BS在各年龄段中差异均无统计学意义。实验组及对照组PWV-ES及PWV-BS值均与年龄呈显著相关(实验组r₁=0.337、r₂=0.173；对照组r₁=0.659、r₂=0.350)。结论： ufPWV技术是评估高血压患者动脉硬化有价值的检测方法，其中PWV-ES和cIMT差异具有统计学意义(P<0.001)。尤其在30~39岁、40~49岁、50~59岁3个年龄段内的高血压人群中更具价值。年龄与ufPWV技术指标及动脉硬化风险密切相关。

Objective: To discuss the influence value of age on carotid artery elasticity, and to perform quantitative evaluation of ultrafast pulse wave velocity(ufPWV) detection in hypertensive patients. Methods: A total of 159 hypertensive patients who underwent physical examination and admission to Jiangsu Provincial Hospital of Chinese Medicine from September 2018 to September 2022 were selected as test group, and 253 patients with normal blood pressure were selected as the control group. The pulse wave velocity at the beginning of contraction(PWV-BS) and the end of contraction(PWV-ES) was measured by the ufPWV detection method, and the carotid intima-media thickness(cIMT) was measured. The subjects were divided into 6 subgroups according to age(19-29Y, 30-39Y, 40-49Y, 50-59Y, 60-69Y, ≥70Y). The PWV-ES and PWV-BS values of hypertensive patients and those of normal blood pressure were compared in different age subgroups. The correlation between PWV-BS and PWV-ES values and age was analyzed in all hypertensive patients and those with normal blood pressure. Results: PWV-BS for hypertension group(6.0±1.7) m/s, PWV-ES(9.0±2.6) m/s, cIMT(0.063±0.026) cm. In the normal blood pressure group, PWV-BS was(6.1±1.4)m/s, PWV-ES was(7.7±2.4) m/s, and cIMT was(0.053±0.010) cm. The analysis results between the two groups showed statistically significant differences in PWV-ES and cIMT(P<0.001). The statistical difference of PWV-BS was not significant(P=0.68). In all age subgroups, PWV-ES differences between hypertensive patients and those with normal blood pressure were statistically significant in only three subgroups: 30-39Y, 40-49Y and 50-59Y(P<0.05, P<0.01 and P<0.001, respectively). There was no significant difference in PWV-BS among all age subgroups. Among all subjects, PWV-ES and PWV-BS values were significantly correlated with age in both hypertensive group and normal blood pressure group(r₁=0.337, r₂=0.173 in hypertensive group and r₁=0.659、r₂=0.350 in normal blood pressure group). Conclusion: ufPWV technique is a valuable method for evaluating arteriosclerosis in hypertensive patients, and PWV-ES and cIMT have statistically significant differences(P<0.001). In particular, it is more valuable in hypertensive population in three age subgroups of 30-39Y, 40-49Y and 50-59Y. Age is closely related to ufPWV technical index and arteriosclerosis risk.

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