慢性肾功能不全和原发性高血压患者颈动脉波强值变化的临床研究  

A Clinical Study on Changes of Carotid Intensity Value in Patients with Chronic Renal Insufficiency and Primary Hypertension

作　　者：肖敏[1] 王茵[1] 曾小凡[1] 王韦[1] 金修才[1] 

机构地区：[1]长海医院超声科,上海200433

出　　处：《解放军医药杂志》2015年第4期81-84,88,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：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。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 instantaneous 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 index（ AI）,vascular compliance（ AC）,duration of ECG R wave to Wl wave crest（ R-w1） and duration of W1 wave to W2wave（ 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 severity of CRF exacerbation（ P〈0. 05）. Parameters such as W1,W2,NA,β,Ep,AI,PWVβ of CRF patients showed positive correlations with indicators such as age,the course of disease,systolic blood

关 键 词：功能不全 慢性 高血压 超声检查 多普勒 脉冲 颈动脉 

分 类 号：R455.1[医药卫生—运动医学]