CAJ | 학술논문

目的：探讨慢性肾功能不全(CRF)和原发性高血压患者颈动脉波强(WI)值变化的意义。方法选取2010年1月—2014年6月收治的56例 CRF 患者为研究对象,分为轻度组22例,中度组18例,重度组16例。将2010年1月—2014年6月收治的40例原发性高血压设为高血压组；另选择同期体检的健康人42例作为对照组。统计所有受试者颈动脉 WI 各参数：瞬时加速波强(W1)、瞬时减速波强(W2)、负向波面积(NA)、硬化参数(β)、应变弹性模量(Ep)、脉搏波传导速度(PWVβ)、管径增大指数(AI)、血管顺应性(AC)、心电图 R 波到 W1波峰时间(R-W1)、W1波到 W2波时间(lst-2nd)；对 CRF 患者颈动脉 WI 各参数与年龄、病程、血压、血肌酐、尿素氮、尿酸等指标进行相关性分析。结果 CRF 组 W1、W2、NA、β、Ep、AI、PWVβ7个参数值均高于高血压组和对照组(P <0．05),且高血压组均高于对照组(P <0．05)。轻、中、重度组此 7个参数值存在明显差异(P <0．05),随着 CRF 严重程度加重,7个参数值呈上升趋势(P <0．05)。 CRF 患者 7个参数值与年龄、病程、收缩压、舒张压、血肌酐、尿素氮、尿酸等指标均呈正相关(P <0．05)。结论颈动脉 WI 用于 CRF 和原发性高血压患者早期心血管功能的监测,具有无创、操作方便等优点。
목적：탐토만성신공능불전(CRF)화원발성고혈압환자경동맥파강(WI)치변화적의의。방법선취2010년1월—2014년6월수치적56례 CRF 환자위연구대상,분위경도조22례,중도조18례,중도조16례。장2010년1월—2014년6월수치적40례원발성고혈압설위고혈압조；령선택동기체검적건강인42례작위대조조。통계소유수시자경동맥 WI 각삼수：순시가속파강(W1)、순시감속파강(W2)、부향파면적(NA)、경화삼수(β)、응변탄성모량(Ep)、맥박파전도속도(PWVβ)、관경증대지수(AI)、혈관순응성(AC)、심전도 R 파도 W1파봉시간(R-W1)、W1파도 W2파시간(lst-2nd)；대 CRF 환자경동맥 WI 각삼수여년령、병정、혈압、혈기항、뇨소담、뇨산등지표진행상관성분석。결과 CRF 조 W1、W2、NA、β、Ep、AI、PWVβ7개삼수치균고우고혈압조화대조조(P <0．05),차고혈압조균고우대조조(P <0．05)。경、중、중도조차 7개삼수치존재명현차이(P <0．05),수착 CRF 엄중정도가중,7개삼수치정상승추세(P <0．05)。 CRF 환자 7개삼수치여년령、병정、수축압、서장압、혈기항、뇨소담、뇨산등지표균정정상관(P <0．05)。결론경동맥 WI 용우 CRF 화원발성고혈압환자조기심혈관공능적감측,구유무창、조작방편등우점。
Objective To study significances of value changes of carotid wave intensity (WI) in patients with chronic renal insufficiency (CRF) and primary hypertension. Methods A total of 56 CRF patients admitted during January 2010 and June 2014 were recruited in this study, and were divided into mild subgroup (n =22), moderate subgroup (n =18) and severe subgroup (n =16) according to the glomerular filtration rate (GFR). A total of 40 patients with essential hypertension admitted during January 2010 and June 2014 were recruited as hypertension group, and 42 healthy people taking physical examination during the same period were selected as control group. Carotid WI parameters in all the groups were recorded, including in-stantaneous accelerating wave intensity (W1), instantaneous decelerating wave intensity (W2), negative wave area (NA), hardening parameter (β), straining elastic modulus (Ep), Mai Bobo conduction velocity (PWV β), calibre augmentation in-dex (AI), vascular compliance (AC), duration of ECG R wave to Wl wave crest (R-w1) and duration of W1 wave to W2 wave (lst-2nd ). Correlation analysis between the carotid WI parameters of CRF patients and age, the course of disease, blood pressure, serum creatinine, urea nitrogen, uric acid and other indicators were performed. Results The values of W1, W2, NA, β, Ep, AI, PWVβ and other parameters of CRF group were higher than that in hypertension and control groups, and they were significantly higher than those of hypertension and control groups (P <0. 05), and the values of hypertension group were higher than those of control group (P < 0. 05). There were significant differences in values of W1, W2, NA, β, Ep, AI, PWVβ and other parameters among mild, moderate and severe groups (P <0. 05), and the values were increased with the se-verity of CRF exacerbation (P <0. 05). Parameters such as W1, W2, NA, β, Ep, AI, PWVβ of CRF patients showed posi-tive correlations with indicators such as age, the course of disease, systolic blood pressure, diastolic blood pressure, serum creatinine, urea nitrogen, and uric acid (P <0. 05). Conclusion Carotid WI in application of monitoring early cardiovascu-lar function in patients with CRF or primary hypertension has advantages such as non-invasion and convenient operation.