超极速脉搏波技术定量评估颈动脉弹性及其与肝脂肪变性指数的相关性  

Quantitative evaluation of carotid artery elasticity and its correlation with hepatic steatosis index by ultra-fast pulse wave technique

作　　者：孙红叶 朱正球[1] 王银萍 马学慧 沈碧潇 刘福明[2] 邹冲[3] 黄辉[1] Sun Hongye;Zhu Zhengqiu;Wang Yinping;Ma Xuehui;Shen Bixiao;Liu Fuming;Zou Chong;Huang Hui(Department of Ultrasound,Jiangsu Province Hospital of Chinese Medicine/Affiliated Hospital of Nanjing Universityof Chinese Medicine,Nanjing 210029,Jiangsu,China;Department of Cardiology,Jiangsu Province Hospital of Chinese Medicine/Affiliated Hospital of Nanjing Universityof Chinese Medicine,Nanjing 210029,Jiangsu,China;Center of Good Clinical Practice,Jiangsu Province Hospital of Chinese Medicine/Affiliated Hospital of Nanjing University ofChinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[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心内科,江苏南京210029 [3]江苏省中医院/南京中医药大学附属医院GCP中心,江苏南京210029

出　　处：《血管与腔内血管外科杂志》2022年第11期1356-1360,共5页Journal of Vascular and Endovascular Surgery

基　　金：江苏省第十六批“六大人才高峰”创新人才团队项目(TD-SWYY-069);江苏省中医药管理局中医药科技发展计划重点项目(ZD201906);江苏省卫生健康委员会老年健康科研项目(LK2021005)。

摘　　要：目的探讨超极速脉搏波(ufPWV)技术定量评估颈动脉弹性及其与肝脂肪变性指数(HSI)的相关性。方法收集2018年1月至2021年9月于江苏省中医院/南京中医药大学附属医院进行体检的336例体检者的临床资料,根据HSI中位值将其分为低HSI组(n=168,HSI≤32.7)和高HSI组(n=168,HIS>32.7)。使用ufPWV技术测量两组体检者的颈动脉弹性参数[收缩起始脉搏波速度(PWV-BS)、收缩末期脉搏波速度(PWV-ES)],记录两组体检者的颈动脉内-中膜厚度(cIMT),比较两组体检者的临床指标,分析PWV-ES、PWV-BS与各项临床指标的相关性,采用多元线性逐步回归分析颈动脉弹性的影响因素。结果两组体检者性别、年龄、身高、体重、体重指数(BMI)、甘油三酯、血糖、尿素、收缩压、舒张压、c IMT、PWV-BS、PWV-ES比较,差异均有统计学意义(P<0.05)。两组体检者低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇、尿酸、肌酐水平比较,差异均无统计学意义(P>0.05)。PWV-ES、PWV-BS与年龄、体重、BMI、尿酸、HSI、收缩压、舒张压、cIMT均呈正相关(P<0.05),与HDL-C均呈负相关(P<0.05),而PWV-ES还与甘油三酯、血糖、肌酐、尿素均呈正相关(P<0.05),且PWV-ES与各指标之间的相关性均高于PWV-BS。多元线性逐步回归分析显示,HSI增高可作为预测PWV-ES增高(动脉僵硬度增高)的危险因素,且其预测价值独立于年龄、舒张压、性别(P<0.05)。结论HSI与PWV-ES及动脉粥样硬化之间存在独立相关性,对于高HSI水平人群进行常规ufPWV检查,定期随访,有助于预测心血管疾病的发生发展,并为潜在心血管疾病或多种危险因素的患者制定适当的治疗方案。Objective To investigate the quantitative evaluation of carotid artery elasticity and its correlation with hepatic steatosis index(HSI)by ultrafast pulse wave velocity(ufPWV)technology.Method The clinical data of 336 cases who underwent physical examination in Jiangsu Province Hospital of Chinese Medicine/Affiliated Hospital of Nanjing University of Chinese Medicine from January 2018 to September 2021 were collected.According to the median level of HSI,they were divided into low HSI group(n=168,HSI≤32.7)and high HSI group(n=168,HIS>32.7).The carotid elasticity parameters of pulse wave velocity at the beginning of systole(PWV-BS)and pulse wave velocity at the end of systole(PWV-ES)of the two groups of physical examiners were measured by the ufPWV technology,the carotid intima-media thickness(cIMT)of the two groups of physical examiners was recorded,the clinical indicators of the two groups of physical examiners was compared,the correlation between PWV-ES and PWV-BS with various clinical indicators was analyzed,the influencing factors of carotid elasticity was analyzed by the multiple linear stepwise regression.Result There were significant differences in sex,age,height,weight,body mass index(BMI),triglyceride,blood glucose,urea,systolic blood pressure,diastolic blood pressure,cIMT,PWV-BS,PWV-ES between the two groups(P<0.05).There were no significant differences in LDL-C,HDL-C,total cholesterol,uric acid and creatinine between the two groups(P>0.05).PWV-ES and PWV-BS were positively correlated with age,weight,BMI,uric acid,HSI,systolic blood pressure,diastolic blood pressure and cIMT(P<0.05),negatively correlated with HDL-C(P<0.05);PWV-ES was also positively correlated with triglycerides,blood glucose,creatinine,and urea(P<0.05),the correlation between PWV-ES and each index was higher than PWV-BS.Multivariate linear stepwise regression analysis showed that the increase of HSI could be used as a risk factor to predict the increase of PWV-ES(the increase of arterial stiffness),and its predictive value was independ

关 键 词：肝脂肪变性指数 超极速脉搏波 颈动脉弹性 

分 类 号：R543[医药卫生—心血管疾病]