老年高血压患者下肢动脉病变与动脉硬化指标的相关性研究
노년고혈압환자하지동맥병변여동맥경화지표적상관성연구
Correlation between atherosclerosis markers and lower limb arterial diseases in elderly patients with hypertension
  • 万方数据
    中国医药 중국의약
    CHINA MEDICINE
    2014年 10期 1436-1440 ,共5页

    刘好田%陶梅英%黄雯%丁红宇

    류호전%도매영%황문%정홍우

    高血压%脉搏波传导速度%踝臂指数%下肢动脉 高血壓%脈搏波傳導速度%踝臂指數%下肢動脈
    고혈압%맥박파전도속도%과비지수%하지동맥
    Hypertension%Pulse wave velocity%Ankle-brachial index%Lower limb artery
    目的 探讨老年高血压患者下肢动脉病变与动脉硬化指标的相关性,为早期防治下肢动脉粥样硬化提供临床依据.方法 88例老年高血压患者进行彩色多普勒超声检查和无创性动脉硬化监测,分别按脉搏波传导速度(baPWV)和踝臂指数分为2组:baPWV增高组(baPWV大于年龄、性别-baPWV标准曲线)和baPWV正常组(baPWV小于年龄、性别-baPWV标准曲线),踝臂指数低值组(踝臂指数≤0.9)和踝臂指数正常组(踝臂指数＞0.9),对2组患者的血管内径,内-中膜厚度(IMT)、收缩期峰值血流速度(pSV)、舒张期末血流速度(EDV)、搏动指数、阻力指数等进行分析.结果 与baPWV正常组相比,baPWV增高组IMT明显增厚[股动脉(1.08±0.16)mm比(0.93±0.13)mm,P＜0.01];胭动脉(1.02±0.16)mm比(90.84 ±0.11)mm,P ＜0.01]、PSV[股动脉(75±16) cm/s比(68±13) cm/s,P＜0.05];胭动脉(50±7)mm比(56±11)mm,P＜0.01]、EDV[股动脉(12.5±2.0)cm/s比(19.6±2.4) cm/s,P＜0.01];胭动脉(10.1±2.0)mm比(14.9±2.7)mm,P＜0.01]和搏动指数(股动脉2.3±1.3比3.6±1.5,P＜0.01;胭动脉4.0±1.9比4.9±2.0,P ＜0.05)明显减低而阻力指数明显增大(股动脉0.82±0.23比0.73±0.18,P＜0.05;胭动脉0.82±0.22比0.73 ±0.20,P＜0.05),差异均有统计学意义.与baPWV正常组相比,baPWV增高组下肢动脉狭窄的发生率更高[91.3％ (42/46)比76.2％(32/42),P＜0.01],狭窄程度更重.同样,与踝臂指数正常组相比,踝臂指数低值组IMT明显增厚[股动脉(1.12±0.18) mm比(0.88 ±0.12) mm,P＜0.01];胭动脉(1.10±0.17)mm比(0.80 ±0.15)mm,P＜0.01]、PSV[股动脉(58±12) cm/s比(80±16) cm/s,P＜0.01];胭动脉(46 ±6)mm比(60±14)mm,P＜0.01]、EDV[股动脉(10.1±1.9) cm/s比(23.3 ±3.2)cm/s,P＜0.01];胭动脉(9.1±2.1)mm比(16.2±3.2)mm,P＜0.01]、搏动指数[股动脉2.2±1.3比3.7±1.7,P＜0.01];胭动脉[3.9±2.0比5.0±2.3,P＜0.05]明显减低而阻力指数(股动脉0.83 ±0.26比0.71 ±0.18,P＜0.05;胭动脉0.83 ±0.28比0.72 ±0.21,P＜0.05)明显增大,差异均有统计学意义.与踝臂指数正常组相比,踝臂指数低值组下肢动脉狭窄的发生率更高[100.0％(38/38)比72.0％(36/50),P＜0.01],狭窄程度更重.结论 联合baPWV和踝臂指数检查对早期发现老年高血压患者下肢动脉粥样硬化具有重要的临床意义.
    목적 탐토노년고혈압환자하지동맥병변여동맥경화지표적상관성,위조기방치하지동맥죽양경화제공림상의거.방법 88례노년고혈압환자진행채색다보륵초성검사화무창성동맥경화감측,분별안맥박파전도속도(baPWV)화과비지수분위2조:baPWV증고조(baPWV대우년령、성별-baPWV표준곡선)화baPWV정상조(baPWV소우년령、성별-baPWV표준곡선),과비지수저치조(과비지수≤0.9)화과비지수정상조(과비지수＞0.9),대2조환자적혈관내경,내-중막후도(IMT)、수축기봉치혈류속도(pSV)、서장기말혈류속도(EDV)、박동지수、조력지수등진행분석.결과 여baPWV정상조상비,baPWV증고조IMT명현증후[고동맥(1.08±0.16)mm비(0.93±0.13)mm,P＜0.01];연동맥(1.02±0.16)mm비(90.84 ±0.11)mm,P ＜0.01]、PSV[고동맥(75±16) cm/s비(68±13) cm/s,P＜0.05];연동맥(50±7)mm비(56±11)mm,P＜0.01]、EDV[고동맥(12.5±2.0)cm/s비(19.6±2.4) cm/s,P＜0.01];연동맥(10.1±2.0)mm비(14.9±2.7)mm,P＜0.01]화박동지수(고동맥2.3±1.3비3.6±1.5,P＜0.01;연동맥4.0±1.9비4.9±2.0,P ＜0.05)명현감저이조력지수명현증대(고동맥0.82±0.23비0.73±0.18,P＜0.05;연동맥0.82±0.22비0.73 ±0.20,P＜0.05),차이균유통계학의의.여baPWV정상조상비,baPWV증고조하지동맥협착적발생솔경고[91.3％ (42/46)비76.2％(32/42),P＜0.01],협착정도경중.동양,여과비지수정상조상비,과비지수저치조IMT명현증후[고동맥(1.12±0.18) mm비(0.88 ±0.12) mm,P＜0.01];연동맥(1.10±0.17)mm비(0.80 ±0.15)mm,P＜0.01]、PSV[고동맥(58±12) cm/s비(80±16) cm/s,P＜0.01];연동맥(46 ±6)mm비(60±14)mm,P＜0.01]、EDV[고동맥(10.1±1.9) cm/s비(23.3 ±3.2)cm/s,P＜0.01];연동맥(9.1±2.1)mm비(16.2±3.2)mm,P＜0.01]、박동지수[고동맥2.2±1.3비3.7±1.7,P＜0.01];연동맥[3.9±2.0비5.0±2.3,P＜0.05]명현감저이조력지수(고동맥0.83 ±0.26비0.71 ±0.18,P＜0.05;연동맥0.83 ±0.28비0.72 ±0.21,P＜0.05)명현증대,차이균유통계학의의.여과비지수정상조상비,과비지수저치조하지동맥협착적발생솔경고[100.0％(38/38)비72.0％(36/50),P＜0.01],협착정도경중.결론 연합baPWV화과비지수검사대조기발현노년고혈압환자하지동맥죽양경화구유중요적림상의의.
    Objective To investigate the correlation between arteriosclerosis markers and lower limb arterial diseases in elderly patients with hypertension; to provide clinical evidence for early prevention of lower limb atherosclerosis.Methods Color Doppler ultrasonography and noninvasive assessment of arteriosclerosis were measured in 88 elderly patients with hypertension.According to pulse wave velocity (baPWV) or ankle-brachial index (ABI),the patients were divided to two groups:high baPWV group (baPWV was higher than age and gender-baPWV standard curve),normal baPWV group (baPWY was lower than age and gender-baPWV standard curve),low ABI group (ABI ≤0.9) and normal ABI group (ABI ＞ 0.9).Results Compared to that in normal baPWV group,interior-medial thickness (IMT) was significantly thicker [femoral artery(1.08 ±0.16)mm vs.(0.93±0.13) mm,P＜0.01]; popliteal artery(1.02±0.16)mm vs.(0.84±0.11)mm,P＜0.01],peak systolic velocity (PSV) [femoral artery (68 ± 13)cm/s vs.(75 ± 16) em/s,P ＜0.05] ;popliteal artery (50 ± 70) cm/s vs (56 ± 11) cm/s,P ＜ 0.01],end diastolic velocity (EDV) [femoral artery (12.5 ± 2.0) cm/s vs.(19.6±2.4) cm/s,P＜0.01]; poplitealartery(10.1±2.0) cm/s vs.(14.9 ±2.7) cm/s,P＜0.01) and pulsatility index (PI) [(femoral artery,(2.3 ± 1.3) vs (3.6 ± 1.5),P ＜ 0.01 ; popliteal artery,(4.0 ± 1.9) vs (4.9 ± 2.0),P ＜ 0.05)] were significantly lower,but resistant index (RI) [femoral artery,(0.82 ± 0.23) vs (0.73 ± 0.18),P ＜ 0.05 ; popliteal artery,(0.82 ± 0.22) vs (0.73 ± 0.20),P ＜ 0.05] was significantly higher in the high baPWV group.There was a higher morbidity of lower limb arterial stenosis and more stenosis in high baPWV group than that in normal baPWV group[91.3％ (42/46) vs 76.2％ (32/42),P ＜0.01].Similarly,compared with that in normal ABI group,IMT was significantly thicker [femoral artery,(1.12 ±0.18) mm vs (0.88±0.12) mm,P＜0.01; poplitealartery,(1.10±0.17) mmvs.(0.80±0.15) mm,P＜0.01],PSV [femoral artery,(58 ± 12) em/s vs.(80± 16) em/s,P＜0.01; popliteal artery,(46±6) em/s vs.(60 ± 14) cm/s,P ＜0.01],EDV [femoral artery,(10.1 ±1.9) cm/s vs.(23.3 ±3.2) cm/s,P＜0.01 ; popliteal artery,(9.1±2.1) cm/svs.(16.2±3.2) em/s,P＜0.01] and PI [femoral artery,(2.2±1.3) vs (3.7± 1.7),P ＜ 0.01 ; popliteal artery,(3.9 ± 2.0) vs (5.0 ± 2.3),P ＜ 0.05) were significantly lower,but RI [femoral artery,(0.83 ±0.26) vs (0.71 ± 0.18),P ＜ 0.05 ; popliteal artery,(0.83 ± 0.28) vs (0.72 ± 0.21),P ＜ 0.05] was significantly higher in the low ABI group.There was a higher morbidity of lower limb arterial stenosis and more stenosis in low ABI group than in normal ABI group[100.0％ (38/38)vs 72.0％ (36/50),P ＜ 0.01].Conclusion baPWV combined with ABI examination has an important clinical value in early diagnosis of lower limb arterial lesions in elderly patients with hypertension.
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