极速脉搏波技术评价多囊卵巢综合征患者颈动脉弹性

目的:初步评价极速脉搏波技术(UFPWV)在多囊卵巢综合征(PCOS)患者颈动脉弹性的应用价值.方法:选取38例PCOS患者为危险组,另选取40例年龄相匹配、月经周期规律的健康成人为对照组.所有受试者均进行了体格检查,并测量血糖、血脂、性激素、颈动脉内中膜厚度(CIMT)、收缩期开始时脉搏波速度(PWVBS)及收缩期结...     

颈动脉脉搏波传播速度与动脉弹性功能关系的临床研究

目的应用组织多普勒显像（TDI）技术探讨原发性高血压患者颈动脉脉搏波传播速度（carotid pulse wave velocity,CPWV）与颈动脉功能变化的关系。方法应用组织多普勒显像技术和M-型超声对67例高血压患者和65例健康人的右颈总动脉进行检测,结合同步心电图描记,测量电-机械时间（electro-mechanical time,EMT）、脉搏波时间（pulse wave time,PWT）、舒张期和收缩期内径,计算颈动脉脉搏波传播速度、僵硬度指数β和顺应性（compliance）。结果高血压组的CPWV显著高于对照组[（3.72±1.50）cm/s和（1.23±0.32）cm/s,P〈0.001]。CPWV与脉压、僵硬度指数β及顺应性密切相关。结论CPWV可作为一项新的评价高血压病动脉功能的指标应用于临床。     

应用血管回声跟踪技术对糖尿病视网膜病变患者颈动脉弹性的临床研究

目的：运用E-Tracking技术检测糖尿病视网膜病变患者的颈动脉弹性。方法：选择2型糖尿病患者90例及健康志愿者30例,测量颈动脉收缩期内径（Ds）、血管内膜中层厚度（IMT）、收缩期峰值流速（PSV）、阻力指数（RI）、压力-应变弹性系数（Ep）、硬化参数（β）、顺应性（AC）、单点脉搏波传导速度（PWVβ）、增大指数（AI）。结果：①与对照组比较,糖尿病A组、B组、C组Ds、PSV、RI无明显差异,糖尿病A组IMT无显著性差异;糖尿病B组IMT有显著性差异（P＜0.05）;糖尿病C组IMT有显著性差异（P＜0.01）;②与对照组比较,糖尿病A组Ep、β测值均明显高于对照组（P＜0.01）,PWVβ、AI高于对照组（P＜0.05）;AC测值低于对照组（P＜0.05）。糖尿病各组间Ep、β、PWVβ、AC测值有统计学差异（P＜0.05）,AI无统计学差异。结论：2型糖尿病患者颈动脉在发生动脉硬化形态学改变之前,其血管内皮功能已存在损伤,糖尿病视网膜病变患者颈动脉弹性减低更为明显。     

血管回声跟踪技术对2型糖尿病患者颈动脉弹性功能的定量检测

目的探讨E-tracking（ET）技术对2型糖尿病患者颈动脉弹性功能的定量检测。方法应用ET技术检测26例2型糖尿病患者及150例正常人的颈动脉弹性指标β、Eρ、AC、AI及PWVβ。26例2型糖尿病患者中,有11例合并高血压和/或终末期肾病,15例不合并。采用SAS6.12统计分析软件比较糖尿病不合并及合并高血压和/或终末期肾病组与正常人颈动脉弹性的差异。结果单纯2型糖尿病患者组仅AI有差异,而合并高血压和/或终末期肾病患者组的β、Eρ、AI及PWVβ均有差异。结论单纯糖尿病患者颈动脉弹性功能仅AI升高,而合并其他疾病者颈动脉弹性功能全面降低;ET技术能够较敏感地定量检测颈动脉弹性功能。     

瞬时波强技术早期评价系统性红斑狼疮患者颈动脉弹性功能

目的：应用瞬时波强（Wave intensity,WI）技术评价绝经期前女性系统性红斑狼疮（Systemic lupus erythematosus,SLE）患者颈动脉血管内皮弹性功能改变,探讨WI技术在早期诊断SLE患者动脉粥样硬化方面的临床应用价值。材料与方法：根据病程将60例女性SLE患者分为SLE 1组（病史<5年）和SLE 2组（病史≥5年）,用WI技术依次检查SLE 1组30例、SLE 2组30例和正常对照组30例,采集WI相关参数瞬时加速度波强（W1）、瞬时减速度波强（W2）、瞬时波强负向波面积（NA）、僵硬度（β）、瞬时波强脉搏波传导速度（PWV-WI）、脉搏波传导速度（PWVβ）、压力应变弹性系数（Ep）、顺应性（AC）、增大指数（AI）及内中膜厚度（IMT）,并进行分析。结果：与正常对照组比较,SLE 1组、SLE 2组患者W2、β、Ep、PWV-WI、PWVβ值增高,AC值降低,差异有统计学意义（P≤0．01）,3组W1、AI、NA值逐渐增高,差异无统计学意义。SLE 2组的W2、PWV-WI、β、Ep、PWVβ均较SLE 1组显著升高,AC显著降低,差异有统计学意义（P≤0．01）。结论：应用WI技术可早期检测SLE患者颈动脉弹性的变化,对临床早期防治心血管并发症的发生具有一定的指导意义。     

2型糖尿病患者颈动脉弹性变化及影响因素

心血管疾病是2型糖尿病患者致残致死的最常见原因。如何早期发现糖尿病的血管损伤及其影响因素，是预防糖尿病心血管病变的关键。血管回声跟踪（echotracking，ET）技术是近年应用于临床的超声新技术，能够动态跟踪和描记动脉壁的运动轨迹并自动计算和显示血管内径的变化幅度，分辨力高达10μm。本研究中我们应用ET技术观察了70例2型糖尿病患者颈动脉弹性参数的改变，旨在分析糖尿病患者颈动脉弹性的变化及其影响因素，以便临床早期发现和预防糖尿病血管损伤。     

瞬时波强技术评价糖尿病患者治疗前后颈动脉弹性功能改变的临床价值

目的探讨瞬时波强(WI)技术评价初诊2型糖尿病患者胰岛素泵强化治疗前后颈动脉弹性功能变化的临床应用价值。方法初诊2型糖尿病患者62例,应用WI技术检测其治疗前和胰岛素泵强化治疗2周后颈总动脉WI参数。另选择体检中心健康志愿者30例作为正常对照组,应用WI技术检测其颈总动脉WI参数。结果糖尿病组血管压力应变弹性模量(Ep)、血管硬化参数(β)、脉搏波传导速度(PWVβ)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)较正常对照组明显增高,瞬时加速度波强(W1)、瞬时减速度波强(W2)、血管顺应性(AC)明显减低,两组之间的差异有统计学意义(P<0.05)。糖尿病组强化治疗后Ep、β、PWVβ较治疗前减低,W1、W2、AC增高,差异有统计学意义(P<0.01,P<0.05)。结论 WI有助于临床评估药物治疗前后糖尿病患者血管弹性功能变化情况,能更客观地量化评估药物疗效。     

QAS技术对2型糖尿病患者颈动脉弹性的评价

目的 探讨定量动脉硬度(QAS)测量技术在评价2型糖尿病患者早期动脉病变中的应用价值.方法 2型糖尿病患者颈动脉无斑块组(A组)75例,有斑块组(B组)64例,正常对照组(C组)106例,应用QAS技术检测颈动脉弹性,比较各组之间颈动脉弹性参数的差异.结果 (1)A组与B组的血管僵硬度系数α、β、脉搏波速度(PWV)均较C组高,顺应性系数(CC)均较C组降低;B组的α、β、PWV较A组高,CC较A组低;(2)各弹性参数间有一定的相关性,尤其是α、β、PWV、CC之间相关性明显.(3)研究指标中β、血管直径(d)、内中膜厚度(IMT)、CC具有统计学意义.结论 2型糖尿病患者颈动脉弹性减低,应用QAS技术能早期发现颈动脉弹性功能的改变,可作为评价糖尿病患者早期血管弹性功能的重要检测方法.     

糖尿病患者颈动脉彩超检测的应用价值

目的 应用彩色多普勒超声检测Ⅱ型糖尿病患者颈动脉病变情况。方法 对117例糖尿病患者双侧颈动脉检测结果与对照组127例健康人群进行比较分析。结果 糖尿病组Ⅲ级粥样斑块检出率(44.4％)与对照组(9.6％)有明显差异(P<0.01);糖尿病组血流速度降低、血管阻力指数及搏动指数增高,与对照组存在差异(P<0.05)。结论 糖尿病患者颈动脉病变以粥样硬化斑块形成、血流减速、血管阻力增高为主要特点。彩超可直观反映病变的分期、轻重程度,在糖尿病血管病变的诊断中具有重要的实用价值。     

急进高海拔地区的抗震官兵颈动脉弹性功能及相关细胞因子的变化初探

目的：应用瞬时波强（WI）技术结合缺氧诱导因子（HIF-1α）及血管内皮生长因子（VEGF）的变化,探讨高海拔低氧环境对急进高原地区的抗震官兵颈动脉弹性功能及相关细胞因子的影响。方法：选取100例急进高原地区7 d的抗震官兵（高原组）和100例平原健康官兵（对照组）,应用WI技术检测两组官兵颈动脉包括压力-应变弹性系数（Ep）、硬化参数（β）、动脉顺应性（AC）、脉搏波反射增强（AI）、脉搏波传导速度（PWV-WI）在内的一系列弹性功能指标,同时检测血液中HIF-1α及VEGF的含量。结果：高原组的HIF-1α及VEGF较对照组均表达上调,PWV-WI增高（P<0.05）。两组间Ep、β、AC、AI无明显差异（P>0.05）。结论：高海拔低氧环境中HIF-1α和VEGF的表达上调可能对动脉弹性功能有调节作用,在反映颈动脉弹性功能的众多指标中,PWV-WI是急进高原地区缺氧反应的敏感指标。     

脉搏波传导速度及波形分析对糖尿病患者动脉弹性功能检测的意义

目的:总结近10年来对脉搏波传导速度及脉搏波形分析在动脉弹性功能检测方面的研究成果,探讨它们在糖尿病患者动脉弹性功能检测中的意义。资料来源:应用计算机检索Medline1991-01/2006-12关于脉搏波传导速度,脉搏波形分析与糖尿病患者动脉弹性关系的文章,检索词“diabetes mellitus,arterial elasticity,pulse wave velocity,pulse wave analysis”,并限定文章的语种为“English”;同时检索中国期刊全文数据库2002-01/2006-09的相关文章,限定文章的语种为中文,检索词“糖尿病,动脉弹性,脉搏波传导速度,脉搏波形分析”。资料选择:对资料进行初审,选择动脉弹性功能检测、心血管危险因素与动脉弹性、脉搏波传导速度与糖尿病,脉搏波形分析与糖尿病等相关文献。排除重复性研究。资料提炼:共收集到相关文献78篇,33篇符合上述标准。其中动脉弹性功能检测相关文献5篇,心血管危险因素与动脉弹性相关文献13篇,脉搏波传导速度与糖尿病相关文献7篇,脉搏波形分析与糖尿病相关文献7篇、糖尿病与冠状动脉粥样硬化性心脏病相关文献1篇。资料综合:糖尿病是重要的心血管危险因素之一,动脉弹性可反映心血管危险因素所致的血管功能损伤。脉搏波传导速度和脉搏波形分析为无创性的反映动脉弹性功能改变的方法,可发现糖尿病患者亚临床的血管病变。文章中还具体介绍了脉搏波传导速度和脉搏波形分析的原理、方法和临床意义。结论:脉搏波传导速度和脉搏波形分析可能在糖尿病血管并发症的早期发现,在危险分层及预后判断中发挥重要作用。     

极速脉搏波技术评价单纯收缩期高血压患者颈动脉弹性

目的应用极速脉搏波技术（UFPWV）评价单纯收缩期高血压（ISH）患者、双期高血压（SDH）患者颈总动脉弹性情况;比较UFPWV技术所检测的颈总动脉前壁心脏收缩起始脉搏波速度（BS）、心脏收缩末期脉搏波速度（ES）值与传统颈总动脉内中膜厚度（IMT）值在早期动脉硬化评估方面的优越性。 方法选取于2017年12月至2018年9月就诊于华北理工大学附属医院的住院患者125例：包括ISH患者42例［（56.69±6.16）岁］、SDH患者39例［（55.97±7.23）岁］、正常血压人群44名为健康对照组［（55.18±8.20）岁］。常规二维测量IMT,采用UFPWV检测BS、ES。对上述各组间的BS、ES及IMT值进行单因素方差分析,组内采用LSD-t检验行两两比较。 结果SDH组IMT、BS值明显高于健康对照组,差异均有统计学意义（t=-2.302、-3.143,P均<0.05）。ISH组IMT、BS、ES值均明显高于健康对照组,差异均有统计学意义（t=-5.024、-3.961、-4.010,P均<0.05）。ISH组BS、ES值均明显高于SDH组,差异均有统计学意义（t=2.596、-2.801,P均<0.05）。 结论ISH患者较SDH患者血管弹性减低明显,更易发生动脉硬化。在评价早期评价动脉硬化方面,UFPWV较常规二维IMT测量更为敏感。     

Measurement of carotid pulse wave velocity using ultrafast ultrasound imaging in hypertensive patients

Purpose

The study aimed to assess the utility of ultrafast ultrasound imaging for evaluation of carotid pulse wave velocity (PWV) in newly diagnosed hypertension patients.

Methods

This prospective non-randomized study enrolled 90 hypertensive patients in our hospital from September to December 2013 as a hypertension group. An age- and sex-matched cohort of 50 healthy adults in our hospital from September to December 2013 was also included in the study as a control group. Carotid PWV at the beginning and at the end of systole (PWV-BS and PWV-ES, respectively) and intima-media thickness (IMT) were measured by ultrafast ultrasound imaging technology. The associations of PWV-BS, PWV-ES, and IMT with hypertension stage were evaluated by Spearman correlation analysis.

Results

PWV-BS and PWV-ES in the hypertension group were significantly elevated compared with those in control group. Different hypertension stages significantly differed in PWV-BS and PWV-ES. PWV-BS and PWV-ES appeared to increase with the hypertension stage. Moreover, IMT, PWV-BS, and PWV-ES were positively correlated with the hypertension stage in hypertensive patients.

Conclusion

Ultrafast ultrasound imaging was a valid and convenient method for the measurement of carotid PWV in hypertensive patients. Ultrafast ultrasound imaging might be recommended as a promising alternative method for early detection of arterial abnormality in clinical practice.

     

2型糖尿病患者肱踝脉搏波传导速度与颈动脉粥样硬化相关性的临床研究

目的探讨2型糖尿病患者肱踝脉搏波传导速度(baPWV)与颈动脉粥样硬化的相关性。方法选取我院内分泌科糖尿病患者88例,根据糖耐量异常程度将其分为T2DM组46例、糖耐量异常组42例;另选同期健康体检者40例作为对照组。彩色多普勒检测颈动脉内-中膜厚度(cIMT),同时动脉硬化检测仪检测baPWV,观察糖尿病患者baPWV与颈动脉脉粥样硬化之间的相关性。结果糖尿病患者cIMT、baPWV明显高于糖耐量异常组和对照组,差异有统计学意义(P<0.05);且cIMT与baPWV呈正相关(r=0.521,P<0.001)。结论糖尿病患者baPWV与颈动脉粥样硬化关系密切,联合cIMT检测对于血管病变的早期诊断、治疗及疗效评估有着重要的意义。     

糖尿病患者心脏舒张功能与动脉弹性功能的关系

目的 探讨2型糖尿病患者的心脏舒张功能和外周动脉脉搏波传导速度(PWV)之间的关系.方法 选取55例2型糖尿病患者,进行心脏彩超、血清B型钠尿肽(BNP)和外周动脉的PWV的检测,根据超声、血清BNP检测结果分成舒张功能正常组33例和舒张功能不全组22例,另取30名健康者作为对照组,比较3组的PWV,并分析超声二尖瓣血流舒张早期峰值速度(E)与瓣环舒张早期峰值速度(E’)的比值(E/E’)与PWV、BNP与PWV的相关性.结果 舒张功能不全的患者动脉PWV较其余两组明显增高[ (770.00±82.11)、(1080.00±158.27)、(1780.00±288.44) cm/s,F =481.605,P＜0.05).调整年龄、性别、血压和血脂后,相关性分析显示E/E’与PWV、BNP与PWV均呈正相关(r=0.58,P＜0.01;r=0.63,P＜0.05).结论 PWV可相应地反映2型糖尿病患者的心脏舒张功能,PWV可作为一种无创性临床指标提示早期舒张性心力衰竭的存在.     

Measurement of pulse wave velocity using pulse wave Doppler ultrasound: comparison with arterial tonometry

Pulse wave velocity (PWV), the speed of propagation of arterial pressure waves through the arterial tree, is related to arterial stiffness and is an important prognostic marker for cardiovascular events. In clinical practice PWV is commonly determined by arterial tonometry, with a noninvasive pressure sensor applied sequentially over carotid and femoral arteries. The electrocardiogram (ECG) is used as a timing reference to determine the time delay or "transit time" between the upstroke of carotid and femoral pulse waveforms. Commercially available vascular ultrasound scanners provide a pulsed wave (PW) Doppler velocity signal, which should allow determination of carotid-femoral transit time and hence PWV. We compared carotid-femoral PWV measured by tonometry and by PW Doppler ultrasound (Seimens, Apsen scanner with 7 MHz linear transducer) in asymptomatic subjects (n = 62, 26 male, aged 21 to 72 y). To test for intra-subject and inter-observer variation, ten subjects were scanned by one observer on two occasions 2 wk apart and by two observers on same day. PWV by tonometry ranged from 5.3 to 15.0 m/s. There was no significant difference between mean values of PWV obtained by the two techniques (mean difference: 0.3 m/s, standard deviation of difference: 1.5 m/s), which were closely correlated (r = 0.83). The coefficient of variation for repeated measures on the same subject by the same observer was 10.1% and the inter-observer coefficient of variation was 5.8%. These results suggest a commercial ultrasound scanner can be used to measure PWV, giving results that are reproducible and closely correlated with those obtained by arterial tonometry. (E-mail: ben_yu.jiang@kcl.ac.uk).     

超声极速成像技术评价冠状动脉慢血流患者颈动脉脉搏波传导速度

目的 采用超声极速成像技术（UF）评价冠状动脉慢血流（CSF）患者颈动脉脉搏波传导速度（PWV）。方法 收集临床诊断为CSF的患者34例（CSF组）和40例健康者（对照组）,进行颈动脉超声检查,测量颈总动脉的内径（D）、内-中膜厚度（IMT）及收缩期峰值血流速度（PSV）,同时采用UF技术测量颈总动脉前壁收缩起始时和结束时PWV（BS和ES）。结果 CSF组的BS和ES均大于对照组（P均<0.05）,而D、IMT及PSV差异均无统计学意义（P均>0.05）。结论 CSF患者的BS和ES增大,CSF可能是动脉硬化的早期表现。UF技术可准确、敏感检测早期动脉硬化。     

2型糖尿病患者强化治疗过程中动脉脉搏波传导速度、踝臂指数及颈动脉斑块变化及分析

目的: 测定2型糖尿病患者接受强化治疗后动脉脉搏波传导速度（pulse wave velocity,PWV）、踝臂指数（ankle-brachial index,ABI）和颈动脉斑块的变化,探讨其临床意义及其在预防2型糖尿病大血管病变方面的监测作用。方法: 选取2012年1月至2014年12月在上海市黄浦区豫园街道社区卫生服务中心随访管理的206例社区2型糖尿病患者,采取随机、对照的干预性研究方法,将患者分为干预组及常规组,比较干预前及24个月后2组患者间血糖、血脂、PWV、ABI和颈动脉超声观察指标的差异。结果: 经2年的强化治疗,干预组与常规组间的收缩压、舒张压、尿蛋白、餐后2 h血糖（2hPG）、糖化血红蛋白（hemoglobin A1c,HbA1c）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）、PWV的差异有统计学意义（P<0.05）。干预组血压达标患者比不达标患者的PWV明显降低,差异有统计学意义（P<0.05）;糖尿病病程（<5年）者HbA1c达标者较不达标者PWV明显降低,差异有统计学意义（P<0.05）。结论: PWV、ABI和颈动脉斑块测定能客观反映2型糖尿病患者经强化治疗后血管结构和功能的变化,对监测、防治2型糖尿病的并发症,延缓或阻止动脉粥样硬化病变发展有一定的指导意义。     

Increased pulse wave velocity reflecting arterial stiffness in patients with colorectal adenomas

The obese patients with diabetes or cardiovascular risk factors are associated with increased risk of colorectal cancer as well as adenomas under the shared pathogenesis related to atherosclerosis. Here we determined the association between increased arterial stiffness and colorectal adenomas incorporating parameters including age, gender, waist circumference, body mass index, lipid profiles, fasting glucose, and blood pressure. Subjects who simultaneously underwent colonoscopies and pulse wave velocity (PWV) determinations between July 2005 and September 2006 were analyzed, based on which the subjects were classified into two groups as patients group with colorectal adenomas (n = 49) and control group (n = 200) with normal, non-polypoid benign lesions or hyperplastic polyps. Uni- and multi-variate analyses were performed to calculate the odd ratio for colon adenomas. Based on uni-variate analysis, age, waist circumference, body mass index, heart-femoral PWV (hfPWV), and brachial-ankle PWV were significantly associated with adenomas (p<0.05) and multiple logistic regression analysis showed that the heart-femoral PWV, waist circumference, and the levels of LDL-C were significant risk factor for colorectal adenoma. However, arterial stiffness did not affect the progression of colon adenoma. The finding that hfPWV, reflecting aortic stiffness, was increased in patients with colorectal adenomas lead to conclusion that patients who have prominently increased arterial stiffness can be recommended to undergo colonoscopic examinations and at the same time we also recommend counseling about the risk for atherosclerosis in those who have colorectal adenomas.     

Piezoelectric sensor determination of arterial pulse wave velocity

Arterial pulse wave velocity (APWV) is a measure of the elasticity (or stiffness) of peripheral arterial blood vessels. The pulse referred to here will be the pressure pulse as opposed to the flow pulse measured by ultrasound Doppler. The pressure pulse velocity varies over the range from about 12 m s(-1) to 15 m s(-1) in stiff peripheral arteries, whereas in normal arteries it has a velocity in the range of 7 to 9 m s(-1). The aim of this project was the development of a fast and easy to use system for the determination of peripheral arterial pulse wave velocity. The principle of the PWV measurement is based on simultaneous measurement of two pulse waves at two different positions, such as the radial artery at the wrist and the brachial artery just above the elbow. By determining the pulse transit time between these points and the distance measured between the two locations, pulse wave velocity may then be calculated. The pressure pulse detection is done by using two piezoelectric sensors which generate a measurable voltage at the output contacts if they are mechanically deformed. The deformation produced voltage is first amplified and filtered and then digitalized with a data acquisition card. The analysis of the data obtained from the sensors includes a filtering process, the calculation of the PWV with three different methods--foot-to-foot, cross-correlation and peak-to-peak-and the determination of the arterial pulse rate. Extensive measurements with human test subjects were carried out to optimize the techniques of data acquisition and analysis. For example, it was found that the best procedure was to hold the sensors in place using elastic straps alone. The data analysis was upgraded with an additional software module, which deletes, in effect, outriders or invalid measurements. With the optimized system, a series involving eight test subjects ranging in age from 22 to 32 years was completed (all normotensive). The arterial pulse wave velocities determined covered a range from 6 m s(-1) to 12 m s(-1), with an average standard deviation of less than 2.5 m s(-1) for individual results. These are slightly higher, but close to published APWV data. The results showed that reproducible results can be obtained with the existing PWV acquirement and analysis system.