超声极速成像技术在单纯夜间高血压患者颈动脉脉搏波传导速度评价中的应用  

The evaluation of carotid pulse wave velocity with ultrafast ultrasound imaging in patients with isolated nocturnal hypertension

作　　者：富维强[1] 刘永馥[2] 何旖旎[3] FU Weiqiang;LIU Yongfu(Department of Cardiovascular Ultrasound,The First Hospital of China Medical University,Shenyang 110001,China 2.Department of Cardiology,The First Hospital of China Medical University,Shenyang 110001,China;Department of General Practice,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳110001 [2]中国医科大学附属第一医院心血管内科,沈阳110001 [3]中国医科大学附属第一医院全科医学科,沈阳110001

出　　处：《中国医科大学学报》2023年第1期68-72,共5页Journal of China Medical University

摘　　要：目的 探讨超声极速成像(UFI)技术在单纯夜间高血压(NH)患者颈动脉脉搏波传导速度(PWV)评价中的应用价值。方法 选取2017年2月至2020年10月我院进行高血压筛查的患者182例,按照血压状况分为血压正常组(白天平均血压<135/85mmHg,且夜间平均血压<120/70 mmHg,n=75)、单纯NH组(白天平均血压<135/85 mmHg,且夜间平均血压≥120/70 mmHg,n=31)、全天高血压组(白天平均血压≥135/85 mmHg,且夜间平均血压≥120/70 mmHg,n=76)。采用常规颈动脉超声测量颈总动脉内-中膜厚度(IMT);采用UFI测量颈总动脉前壁收缩起始时PWV和收缩结束时PWV。结果 与血压正常组比较,全天高血压组和单纯NH组颈总动脉前壁收缩结束时PWV均增大(均P <0.05);而与全天高血压组比较,单纯NH组收缩结束时PWV减小(P <0.05)。3组收缩起始时PWV及IMT比较差异均无统计学意义(均P> 0.05)。多元线性回归分析显示,全天高血压和单纯NH患者夜间平均收缩压和平均舒张压均与颈总动脉前壁收缩结束时PWV相关(均P <0.05)。结论 单纯NH患者颈总动脉收缩结束时PWV增大。UFI可以准确评价单纯NH患者颈动脉硬度,为临床及时制定治疗方案并评估疗效提供参考依据。Objective To investigate the application value of ultrafast ultrasound imaging(UFI) technology in the evaluation of carotid pulse wave velocity(PWV) in patients with isolated nocturnal hypertension(NH). Methods One hundred and eighty-two patients who underwent hypertension screening in our hospital from February 2017 to October 2020 were selected and divided into the normotensive group(mean daytime blood pressure <135/85 mmHg and mean nocturnal blood pressure <120/70 mmHg,n = 75),the isolated NH group(mean daytime blood pressure <135/85 mmHg and mean nocturnal blood pressure ≥120/70 mmHg,n = 31),and the all-day hypertension group(mean daytime blood pressure ≥135/85 mmHg and mean nocturnal blood pressure ≥120/70 mmHg,n = 76). The common carotid artery intra-medial thickness(IMT) was measured using conventional carotid ultrasonography;UFI was used to assess PWV at the onset of systole and PWV at the end of systole in the anterior wall of the common carotid artery. Results Compared with the normotensive group,PWV at the end of systole was increased in both the all-day hypertensive group and the isolated NH group(all P < 0.05),whereas PWV at the end of systole was decreased in the isolated NH group compared with the all-day hypertensive group(P < 0.05). The differences in PWV and IMT at systole onset were not statistically significant among the three groups(all P > 0.05). Multiple linear regression analysis revealed that in patients with all-day hypertension and isolated NH,the mean systolic and diastolic blood pressure at night were correlated with PWV at the end of systole(all P < 0.05). Conclusion The PWV at the end of systole was increased in patients with isolated NH,and UFI can accurately evaluate the carotid stiffness in patients with isolated NH,which provides a reference basis for the clinical formulation of treatment plans and the assessment of efficacy in a timely manner.

关 键 词：夜间高血压 脉搏波传导速度 超声极速成像 应用 

分 类 号：R445.1[医药卫生—影像医学与核医学]