基于UFPWV的颈动脉硬化与高血压中医证型相关性分析

目的:应用极速脉搏波成像(UFPWV)技术测定颈动脉脉搏波速度(PWV),探讨颈动脉血管弹性与高血压中医证型的相关性,为早期预测动脉硬化及中医辨证施治提供新的无创诊断途径。方法:选取2018年1月—2019年3月来院心内科治疗的1~2级高血压患者100例(196条颈动脉),测量颈动脉内中膜厚度(IMT),收缩早期脉搏波速度(PWVBS)和收缩末期脉搏波速度(PWVES),比较其各组间的差异。结果:各中医证型高血压患者的收缩压、舒张压均高于正常组(P<0.05);PWVBS、PWVES与血压呈正相关,高血压患者各中医证型PWVBS及PWVES值均明显高于正常组(P<0.05),肝火亢盛证及痰湿壅盛证L-PWVES(左侧)值明显低于气阴两虚证(P<0.05);肝火亢盛证R-PWVES(右侧)值明显低于气阴两虚证(P<0.05)。结论:UFPWV技术能够早期、简便、准确地反映高血压血管弹性功能的变化,气阴两虚证高血压患者发生动脉硬化的危险性更大。

Correlation Analysis on TCM Syndromes of Carotid Atherosclerosis and Hypertension Based on UFPWV

Objective:To investigate the correlation between carotid artery elasticity and TCM syndrome types of hypertension by measuring PWV with UFPWV technique,and to provide a new non-invasive diagnostic approach for early prediction of arteriosclerosis and for TCM syndrome differentiation and treatment.Methods:IMT,PWVBS and PWVES were measured in 196 carotid arteries of 100 patients with class 1~2 hypertension from January 2018 to March 2019,and the differences were compared between the groups.Results:The systolic blood pressure and the diastolic blood pressure were higher in hypertension patients with TCM syndrome patterns than those in the normal group(P<0.05).PWVBS and PWVES were positively correlated with blood pressure,the values of PWVBS and PWVES were significantly higher in hypertension patients with TCM syndrome patterns than those in the normal group(P<0.05).The value of L-PWVES(left side)was lower in the syndrome of excess of Liver-fire and excess of phlegm-dampness than that in the syndrome of deficiency of both qi and yin(P<0.05).The value of R-PWVES(right side)was lower in the syndrome of excess of Liver-fire and excess of phlegm-dampness than that in the syndrome of deficiency of both qi and yin(P<0.05).Conclusion:The UFPWV technique can reflect the changes of the elastic function of blood vessels in hypertension in early stage,and the patients with deficiency of both qi and yin have a higher risk of arteriosclerosis.