中老年高血压患者肾内动脉血流动力学变化与动态动脉硬化指数和脉压的相关性分析  

Analysis of the correlation of hemodynamic changes in the renal artery with the ambulatory arterial stiffness index and pulse pressure in middle-aged and elderly hypertension patients

作　　者：高媛媛[1] 李硕[2] 朱仕芳[1] 叶静[1] 王晓娟[1] Gao Yuanyuan;Li Shuo;Zhu Shifang;Ye Jing;Wang Xiaojuan(General Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China;Department of Medical Ultrasound,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020.China)

机构地区：[1]首都医科大学附属北京朝阳医院综合科,北京100020 [2]首都医科大学附属北京朝阳医院超声医学科,北京100020

出　　处：《中华老年医学杂志》2023年第12期1464-1467,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨通过对肾内动脉阻力指数(RI)与动态动脉硬化指数(AASI)和脉压的相关性分析, 判断高血压性肾血管损害程度。方法回顾性病例对照研究, 选取2018年5月至2023年5月首都医科大学附属北京朝阳医院综合科高血压患者1 226例, 行肾动脉血流动力学检查, 血流异常患者187例, 其中肾动脉狭窄组78例, 无肾动脉狭窄组109例;肾动脉血流正常患者(对照组)1 039例。对比高血压患者不同程度肾血流阻力增高的AASI、脉压;采用Spearman秩和相关分析评估老年高血压患者AASI、脉压与肾损伤程度的相关性;高血压患者肾血流动力学异常者肾动脉狭窄和RI、AASI、脉压检查结果的受试者工作特征曲线(ROC)分析。结果肾动脉狭窄组、无肾动脉狭窄组和对照组患者RI[(0.83±0.05)、(0.78±0.02)、(0.71±0.03)]、AASI[(0.61±0.05)、(0.58±0.06)、(0.37±0.05)]、脉压[(1.71±0.15)、(1.44±0.22)、(0.88±0.25)]比较, 差异有统计学意义(F值分别为410.44、734.77、968.99, 均P<0.01), 肾动脉狭窄组与无肾动脉狭窄组和对照组比较, 差异亦有统计学意义(F值分别为66.34、9.87和160.51, 均P<0.05)。Pearson相关性分析结果显示, RI与AASI、脉压呈正相关(r值跟别为0.730、0.762, 均P<0.01)。RI=0.77、AASI=0.52、脉压=1.31分别为老年高血压患者发生肾动脉狭窄的截断值, 曲线下面积分别为0.897、0.830和0.951(均P<0.05);敏感性分别为87%、95%、98%, 特异性分别为68%、67%、71%。结论 RI、AASI、脉压可有效预测中老年高血压患者肾动脉损害情况。Objective To assess the extent of hypertensive renal vascular damage by analyzing the correlation of the renal artery resistive index(RI)with the ambulatory arterial stiffness index(AASI)and pulse pressure.Methods A retrospective case-control study was conducted enrolling 1226 hypertension patients from the General Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University between May 2018 and May 2023,and the hemodynamics of the renal artery were examined,with 187 patients showing abnormal blood flow,of whom,78 were in the group with renal artery stenosis and 109 were in the group without renal artery stenosis,and 1,039 had normal renal arterial blood flow(the control group).AASI and pulse pressure values were compared between hypertension patients with different degrees of increased resistance to renal blood flow;Spearman's rank correlation analysis was conducted to assess the correlation of AASI and pulse pressure with the degree of renal injury in elderly hypertension patients;The receiver operating characteristic(ROC)curves were plotted for hypertension patients with renal hemodynamic abnormalities based on the existence of renal artery stenosis and the results of RI,AASI and pulse pressure.Results Patients in the renal artery stenosis,no renal artery stenosis,and control groups had statistically significant differences in RI[(0.83±0.05),(0.78±0.02),(0.71±0.03),F=410.44,P<0.01],AASI[(0.61±0.05),(0.58±0.06),(0.37±0.05),F=734.77,P<0.01],and pulse pressure[(1.71±0.15),(1.44±0.22),(0.88±0.25),F=968.99,P<0.01];Comparedwith the group with no renal artery stenosis and the control group,the renal artery stenosis group also showed statistically significant differences in values of the three parameters(F=66.34,9.87 and 160.51,respectively,P<0.05 for all).Pearson correlation analysis showed that RI was positively correlated with AASI and pulse pressure(r=0.730 and 0.762,respectively,P<0.01 for both).The cut-off value was 0.77 for RI.0.52 for AASI and 1.31 for pulse pressure for renal arte

关 键 词：高血压 血管阻力 动脉阻力指数 动态动脉硬化指数 

分 类 号：R544.1[医药卫生—心血管疾病]