超极速脉搏波技术定量评估年龄相关颈动脉弹性衰退的应用价值及平均动脉压对其的影响

目的:探讨超极速脉搏波(ufPWV)技术在定量评估年龄相关颈动脉弹性衰退的应用价值及平均动脉压对其的影响。方法:选取健康成人138例,具有动脉粥样硬化危险因素患者297例,共435例,再根据年龄段(25~<35岁、35~<45岁、45~<55岁、55~<65岁及≥65岁)划分为5组。所有入组对象均收集详细临床资料,利用ufPWV技术检测双侧颈动脉收缩起始脉搏波速度(PWV-BS)和收缩末期脉搏波速度(PWV-ES)。分析PWV-BS、PWV-ES及平均动脉压(MAP)与年龄的相关性,比较各年龄段间PWV-BS及PWV-ES的差异,并根据MAP分层后,探讨血压对ufPWV测值可能的影响。结果:PWV-BS、PWV-ES及MAP与年龄均呈显著正相关(分别r=0.25,P<0.001;r=0.615,P<0.001;r=0.25,P<0.001);PWV-BS、PWV-ES均随着年龄的增长而逐渐增高,其组间差异有显著统计学意义(P均<0.001);高MAP亚组(MAP≥100 mmHg)及低MAP亚组(MAP<100 mmHg)PWV-ES均随年龄的不断增长而增高,25~<35岁、35~<45岁、45~<55岁、55~<65岁各年龄段高MAP亚组PWV-ES明显高于低MAP亚组(P均<0.05),而在≥65岁年龄段并无明显差异(P=0.126)。结论:不同平均动脉压可显著改变ufPWV技术定量评估年龄相关的颈动脉弹性测值,在临床应用该技术检测动脉弹性时应注意不同血压及年龄对其的影响。

The application value of quantitative assessment of age-related reduction of carotid artery elasticity by ultrafast pulse wave velocity and the effect of mean arterial pressure on it

Objective:To explore the application value of quantitative assessment of age--related reduction of carotid artery elasticity by ultrafast pulse wave velocity and the effect of mean arterial pressure on it.Methods:A total of 435 patients,138 healthy adults and 297 patients with risk factors for atherosclerosis were enrolled,and divided into 5 groups according to age intervals(25~<35,35~<45,45~<55,55~<65,≥65 years old).Detailed clinical data were collcted from all the enrolled subjects,and pulse wave velocity of beginning systole(PWV-BS)and pulse wave velocity of ending systole(PWV-ES)of bilat-eral carotid artery were measured by ufPWV technology.The correlations between PWV-BS,PWV-ES,MAP and age were analyzed.Then the differences of PWV-BS and PWV-ES among different age intervals were compared,and the possible influ-ence of blood pressure on ufPWV detection was further analyzed according to the stratification of mean arterial pressure(MAP).Results:There were great significant correlations between age and PWV-BS(r=0.25,P<0.001),PWV-ES(r=0.615,P<0.001),MAP(r=0.25,P<0.001).Both PWV-BS and PWV-ES were increased with age(P<0.001).When divided by MAP categories,the PWV-ES of the high MAP subgroup(MAP≥100 mmHg)and the low MAP subgroup(MAP<100 mmHg)both increased with age.The PWV-ES of the high MAP subgroup were signifcantly higher than those of the low MAP subgroup at the age intervals of 25~<35,35~<45,45~<55,55~<65 years old(all P<0.05),but there was no significant difference at the age interval of≥65(P=0.126).Conclusions:Different mean arterial blood pressure has significant influence on the quantitative evaluation of age-re-lated carotid arterial elastic degeneration by ufPWV,so the effect of different blood pressure and age on the measured value of carotid artery elasticity should be noted in the clinical application of this technology.