动态误差分析系统对高血压病人脉搏波速度测量结果的影响

目的：研究不同误差状态的设置对高血压脉搏波速度（PWV）检测结果的影响。方法和材料：选择270名年龄在46～80岁的健康体检人群，男女各半。分别采用国际上先进的脉搏波速度测定系统Complior仪检测受检人群不同节段的PWV值。颈股CF—PWV、颈挠CR—PWT、颈远端CD—PWV，分别反映主动脉、上肢动脉和下肢动脉的僵硬度。将3组受检人群检测时动态误差在分别设置为15％〉误差〉10％、10％〉误差〉5％、5％〉误差三种状态下，重复测量各节段的PWV值，观察不同误差设置对检测结果的影响。结果：动态误差在10％〉误差〉5％，5％〉误差两种状态下各组人群的各节段PWV值无显著差异；而动态误差在15％〉误差〉10％时，与动态误差〈5％组比较，各节段PWV值的差异显示出统计学意义。结论：动态误差分析系统对PWV检测结果会有不同影响，选择误差较小的检测模式有利于提高检测结果的准确性。检测时只要误差控制在10％以下，对检测结果重复性和可靠性不会产生影响。     

老年高血压患者脉压和动脉弹性的临床研究

目的探讨老年高血压患者脉压与动脉弹性功能的相关性。方法对195例老年高血压患者和205例健康人员进行脉压和脉搏波速度（PWV）检测。结果高血压组与对照组比较,脉压、P、W差异有统计学意义（均P〈0．05）结论脉压与PWV密切相关．脉压与PWV不仅为动脉血管损伤的预测指标,而且可预测动脉功能的损伤程度。     

动态误差分析系统对脉搏波速度测量结果的影响

目的研究不同误差状态的设置对脉搏波速度(PWV)检测结果的影响。方法和材料选择90名年龄在(18～40)岁的健康体检人群,男女各半。分别采用国际上先进的脉搏波速度测定系统Complior仪检测受检人群不同节段的PWV。颈股CF-PWV、颈桡CR-PWV、颈远端CD-PWV,分别反映主动脉、上肢动脉和下肢动脉的僵硬度。将3组受检人群检测时动态误差在分别设置为15%>误差>10%、10%>误差>5%、5%>误差三种状态下,重复测量各节段的PWV值,观察不同误差设置对检测结果的影响。结果动态误差在10%>误差>5%,5%>误差两种状态下各组人群的各节段PWV值无显著差异;而动态误差在15%>误差>10%时,与动态误差<5%组比较,各节段PWV值的差异显示出统计学意义。结论动态误差分析系统对PWV检测结果会有不同影响,选择误差较小的检测模式有利于提高检测结果的准确性。     

代谢综合征患者大动脉顺应性与颈动脉内-中膜厚度变化的研究

目的 探讨代谢综合征（MS）患者大动脉顺应性及颈动脉内-中膜厚度（IMT）的变化。方法 64例MS患者和56例年龄相匹配的正常对照者，测定所有人选者颈动脉-股动脉的脉搏波速度（PWV）、颈动脉IMT，同时检测其身高、体重、腰围、臀围、血压、血糖、血脂水平，并计算体重指数（BMI）、腰臀比（WHR）。结果 MS组PWV和颈动脉IMT与对照组比较，差异有统计学意义（P〈0．05）。MS组颈动脉IMT与年龄、腰围、收缩压、脉压、总胆固醇、甘油三酯、PWV呈显著正相关（P〈0．01），与高密度脂蛋白-胆固醇呈显著负相关（P〈0．01）；PWV与年龄、收缩压、脉压、体重指数、总胆固醇、甘油三酯、颈动脉IMT、体重呈显著正相关（P〈0．05），与高密度脂蛋白-胆固醇呈显著负相关（P〈0．01）。结论 MS患者PWV及颈动脉IMT均明显升高，已经存在大动脉顺应性的减退；MS患者大动脉顺应性的变化与年龄、血压、肥胖及血脂紊乱有关，且PWV与颈动脉IMT有明显的相关性。     

血管回声跟踪技术对脑卒中患者颈动脉弹性功能的定量检测

目的探讨脑卒中患者颈动脉弹性功能改变及临床应用价值。方法应用血管回声跟踪技术检测75例脑卒中患者颈动脉弹性参数,包括硬化度（β）、压力应变弹性系数（Ep）、顺应性（AC）、脉搏波传导速度（PWVβ）和膨大指数（AI）,对比分析脑卒中患者与正常对照者颈动脉弹性差异。结果脑卒中患者颈动脉硬化度（β）、弹性系数（Ep）、脉搏波传导速度（PWVβ）和膨大指数（A1）均较正常对照组增高（P〈0．01）,脑卒中患者顺应性（AC）改变与正常对照组比较差异无统计学意义（P〉0．05）。结论血管回声跟踪技术能够定量检测脑卒中患者颈动脉弹性变化,对指导临床治疗及评价预后有一定的临床应用前景。     

应用E—Tracking技术评价高血压早期颈动脉血管病变

目的探讨回声跟踪（E—Tracking）技术评价高血压早期颈动脉血管病变的价值。方法对60例高血压患者（EH组）和30例正常人（对照组）采用E—Tracking技术实时跟踪描记颈总动脉管壁运动轨迹，得出颈总动脉的收缩期内径（Ds）、舒张期内径（Dd）、弹性系数（Ep）、硬化值（B）、脉搏波传导速度（PWV）和顺应性（AC），并将高血压组各项指标与对照组比较。结果EH组与对照组比较，左、右颈总动脉Ep、β和PWV均升高（P〈0．01或〈0．05），AC降低（P〈0．01）；两组Ds和Dd比较，差异无统计学意义（P〉0．05）。EH组左、右颈总动脉上述各项指标比较，差异均无统计学意义（P〉0．05）。结论E—Tracking技术能较早地反映大动脉血管病变。     

心血管危险因素对动脉僵硬度的影响

目的探讨心血管危险因素与动脉僵硬度的相关性。方法对486确体检者进行心血管危险因素调查和测定脉搏波速度（PWV）。结果相关分析显示收缩压（r=0．426，P=0．001）、脉压（r=0．381，P=0．002）、年龄（r=0．356，P=0．002）、血糖（r=0．262，P=0．035），甘油三酯（r=0．215，P=0．038）、低密度脂蛋白胆固醇（r=0．192，P=0．042）等心血管主要危险因素与PWV呈显著正相关。结论PWV-9心血管危险因素有较高的相关性，对心血管事件的预测有一定价值。     

脉搏波传导速度与脑血管疾病发病风险的相关关系的病例对照研究

摘要:目的　探讨颈股脉搏波传导速度（cfPWV）和颈桡动脉搏波传导速度（crPWV）与脑血管损伤的相关关系。方法　从2012年1月-2013年12月在凉山州州一医院神经内科诊断为急性脑梗死患者98例和脑出血患者92例,并纳入同期对照96例。采用脉搏波速测定仪进行测定一侧颈动脉-股动脉脉搏波速度（cfPWV）和颈动脉-桡动脉脉搏波速度（crPWV）。结果　脑梗死组和脑出血组与对照组相比,更易吸烟、饮酒、患高血压和糖尿病,差异有统计学意义（P＜0.05）。脑梗死组和脑出血组与对照组相比,TG、TC、HDL-C和LDL-C水平均高于对照组,差异有统计学意义（P＜0.05）。脑梗死组和脑出血组的cfPWV和crPWV水平与对照组相比,差异有统计学意义（P＜0.05）。急性脑梗死患者不同面积PWV和脑出血不同部位PWV水平差异无统计学意义（P＞0.05）。结论　PWV测定是一种无创性检测动脉弹性的方法,能够提供中心大动脉的弹性参数,对评估血管功能状态有重要的价值,能够采用该方法对脑血管疾病进行提前筛查,达到二级预防的效果。     

应用动脉硬化指标评价老年单纯收缩期高血压患者的血管健康状况

目的应用脉搏波传导速度（PWV）、踝臂指数（ABI）和颈动脉内膜中层厚度（IMT）评价老年单纯收缩期（ISH）高血压在杓型与非杓型血压昼夜节律变化时的血管健康状况。方法按照动态血压仪检测结果,分为非杓型组（74例）、杓型组（78例）和正常血压组（72例）,观察试验组和对照组baPWV、ABI、IMT。结果非杓型组肱-踝脉搏波速度（baPWV）、IMT值显著高于杓型组（baPWV1801．614±314．27,1658．674±274．80,P〈0．01;IMT0．964±0．22,0．874±0．19,P〈0．05）,ABI值显著低于杓型组（1．034±0．17,1．12±0．18,P〈0．01）。当baPWV〉1400cm／s、ABI〈0．9时,三组检出数依次为61例、59例、41例,以及18例、9例、5例,差异有统计学意义（χ^2=12．57,P〈0．01;χ^2=9．74,P〈0．01）;三组颈动脉斑块检出数依次为43例、32例、18例,差异有统计学意义（χ^2=16．49,P〈0．01）。结论老年ISH患者易出现外周动脉损害,非杓型高血压尤为明显,无创性baPWV、ABI、IMT指标可较好的评价血管健康状态。     

动态动脉硬度指数与脉搏波速度的相关性研究

目的研究动态动脉硬度指数（AASI）与脉搏波速度（PwV）的相关性，探讨AASI对动脉硬化程度的评价价值，并分析AASI的影响因素。方法入选患者100例，进行臂-踝PwV测量，并同时进行24h动态血压监测（ABPM），计算AASI。应用直线相关分析判定AASI与PwV的相关性。并应用多因素逐步回归分析判定AASI的影响因素。结果AASI与PWV和年龄显著正相关（PWV：r=0．516，P〈0．01；年龄：r=0．417，P〈0．01）。AASI与身高呈负相关（r=-0．223，P〈0．05）。多因素逐步分析结果表明，PWV是与AASI关系最密切的参数。结论AASI与PwV相关性良好，是一个反映动脉硬化程度的新指数。     

基于个性化脉搏波传导参数的连续血压测量方法研究

目的：建立基于个性化脉搏波传导参数的连续血压测量方法模型。方法对18名受试者进行了运动实验,在运动实验过程中连续记录受试者的心电和手指容积脉搏波,同时利用动态血压计每2 min采集受试者的血压;每个受试者间隔1周的时间进行第二次实验;采用最小均方误差线性估计的方法来建立脉搏波传导时间和收缩压之间的线性模型。结果同一个受试者脉搏波传导时间与收缩压具有良好的线性关系（r2=0.91±0.06）,线性模型的检测误差为（3.48±1.69）mmHg,且具有较好的稳定性。但对于不同受试者,很难建立统一的线性模型（r2=0.14）。结论基于个性化脉搏波传导参数的连续血压测量方法是可行的,有望实现无袖带的连续血压测量。     

The effects of smoking on the relationship between metabolic syndrome and arterial stiffness

It has been reported that arterial stiffness assessed by pulse wave velocity (PWV) can predict cardiovascular morbidity and mortality. Metabolic syndrome and smoking are independently associated with increased risk of cardiovascular disease. The purpose of this study was to evaluate the effect of smoking on the relationship between metabolic syndrome and arterial stiffness. We retrospectively enrolled 1,530 men on whom brachial-ankle pulse wave velocity (baPWV) measurement had previously been performed as part of health screening at Kosin University Hospital. We found that PWV was positively correlated with the following variables: age (r = 0.391, P < 0.0001), systolic blood pressure (r = 0.438, P < 0.0001), diastolic blood pressure (r = 0.377, P < 0.0001), low-density lipoprotein (LDL) (r = 0.068, P = 0.008) and high-density lipoprotein (HDL) (r = 0.027, P = 0.287), whereas BMI was negatively correlated, although without statistical significance (r = -0.026, P = 0.309). Among current smokers, PWV decreased with increasing BMI (from 1,387.9 to 1,311.6), and increased with increasing HDL (from 1,342.7 to 1,385.4). On the other hand, among never smokers, PWV increased with increasing BMI (from 1,382.3 to 1,458.8), and decreased with increasing HDL (from 1,391.2 to 1,369.7). PWV was inversely associated with BMI and HDL, and these differences are likely due to smoking.     

心血管危险因素对动脉僵硬度的影响

目的探讨心血管危险因素与动脉僵硬度的相关性。方法对486例体检者进行心血管危险因素调查和测定脉搏波速度(PWV)。结果相关分析显示收缩压(r=0.426,P=0.001)、脉压(r=0.381,P=0.002)、年龄(r=0.356,P=0.002)、血糖(r=0.262,P=0.035),甘油三酯(r=0.215,P=0.038)、低密度脂蛋白胆固醇(r=0.192,P=0.042)等心血管主要危险因素与PWV呈显著正相关。结论PWV与心血管危险因素有较高的相关性,对心血管事件的预测有一定价值。     

A segmental evaluation of arterial stiffness before and after prolonged strenuous exercise

We aimed to investigate the effects of a single session of prolonged strenuous exercise (PSE) on arterial stiffness by measuring pulse wave velocity (PWV) before and after competition in an ultramarathon. A total of 20 routine ultramarathon competitors (UM) completed baseline and postrace evaluation of central PWV (cPWV), upper-limb PWV (uPWV), and lower-limb PWV (lPWV) using carotid artery - femoral artery, carotid artery - finger, and femoral artery - toe segments, respectively. Fourteen additional age- and gender-matched normally active participants (NA) took part in the identical baseline evaluation but did not participate in the race. Average ultramarathon completion time was 30 h 47 min. Mean arterial blood pressure was reduced after exercise (before exercise (pre), 92 ± 7 mm Hg; after exercise (post), 84 ± 7 mm Hg; P < 0.001), whereas heart rate was increased (pre, 57 ± 10 beats·min(-1); post, 73 ± 12 beats·min(-1); P < 0.001). Also, lPWV (pre, 11.8 ± 3.6 m·s(-1); post, 9.6 ± 2.6 m·s(-1); P < 0.05) and uPWV (pre, 5.0 ± 0.53 m·s(-1); post, 4.4 ± 0.8 m·s(-1); P < 0.01) were reduced after exercise. No change in cPWV occurred (pre, 4.1 ± 0.8 m·s(-1); post, 3.9 ± 1.3 m·s(-1); P = 0.55). At baseline, the NA group had significantly increased cPWV in comparison with the UM group (UM, 4.1 ± 0.8 m·s(-1); NA, 7.4 ± 1.3 m·s(-1); P < 0.001). Acute participation in PSE influenced peripheral but not central arterial stiffness. Those who routinely participate in PSE have reduced central arterial stiffness as compared with normally active, age- and gender-matched controls.     

Relationship between serum albumin and pulse wave velocity in patients on continuous ambulatory peritoneal dialysis

Background:

Hypoalbuminemia is a risk factor for cardiovascular events and mortality in dialysis patients, but the underlying mechanism remains unclear. Meanwhile, increased pulse wave velocity (PWV), the marker of arterial stiffness, has been proved to be an independent predictor of cardiovascular disease. The relationship between serum albumin and PWV in continuous ambulatory peritoneal dialysis patients (CAPD) was studied.

Methods:

Sixty-two CAPD patients were studied. The average age was 63 ± 12 years and dialysis duration was 23 ± 22 months. Serum albumin, C-reactive protein (CRP), and carotid-femoral PWV were measured.

Results:

Among these patients, 43.5% were men. The mean serum albumin concentration was 37 ± 4 g/L and PWV was 11.9 ± 2.3 m/s. PWV positively correlated with age (r = 0.35, P < 0.01), diabetes (yes = 1, no = 0; r = 0.292, P < 0.05), systolic blood pressure (SBP; r = 0.493, P < 0.001) and CRP (r = 0.295, P < 0.05), but negatively correlated with serum albumin (r = –0.357, P < 0.01). In multiple regression analysis, SBP (β = 0.615, P < 0.001), age (β = 0.414, P < 0.01), albumin (β = –0.315, P < 0.05) and total cholesterol (β = 0.275, P < 0.05) were independent determinants of PWV. In a non-inflamed subgroup (CRP < 3 mg/L, n = 30), albumin still negatively correlated with PWV (r = −0.66, P < 0.001).

Conclusion:

Serum albumin inversely correlated with increased PWV in CAPD patients, suggesting that increased arterial stiffness might be the link between hypoalbuminemia and increased cardiovascular mortality in dialysis patients.     

口服α一硫辛酸对超重或肥胖患者脉搏波速度和卧位血压影响的随机、双盲、安慰剂对照、交叉试验研究

目的 探讨超重或肥胖患者口服抗氧化剂α-硫辛酸(ALA)对臂踝脉搏波速度(baPWV)、卧位收缩压(sSBP)和卧位舒张压(sDBP)的影响,为超重或肥胖相关心血管疾病的预防提供理论依据.方法 采用随机、双盲、安慰剂对照和交叉试验设计.按照入选标准(20～60岁汉族、BMI≥25 kg/m2和未服用任何抗氧化剂等)纳入研究对象103人(男性63人、女性40人).采用分层区组随机化设计方法将研究对象随机分到ALA组(52人)或安慰剂组(51人)进行为期8周的干预,剂量为1200mg/d.经过4周洗脱期后,两组干预措施交换再干预8周.基线测量包括问卷调查、人体测量、血压测量、脉搏波速度、卧位血压、血液生化指标的检测.两阶段起始和终末均采用统一的检测方法和同一批调查员.采用Stata 11.0软件进行混合效应模型分析.结果 ALA组和安慰剂组人体测量指标和生化指标的基线水平均衡可比(P＞0.05).经口服ALA 8周后,ALA组baPWV降低(-33.03±130.70)cm/s,安慰剂组升高(5.66±139.89)cm/s,两组差异无统计学意义(P=0.078).ALA组sSBP降低(-4.09±9.18)mm Hg,安慰剂组降低(-2.32±8.16)mm Hg,两组差异无统计学意义(P=0.067);ALA组sDBP降低(-1.29±6.55)mm Hg,安慰剂组降低(-0.48±6.63)mm Hg,但两组差异无统计学意义(P=0.595).混合效应模型分析结果显示,在控制了试验顺序、阶段等因素后,两组间baPWV、sSBP和sDBP的差异均无统计学意义.结论 ALA 1200mg/d口服8周,不能明显降低动脉硬度和卧位血压水平.

Abstract：

Objective To investigate the effect of oral alpha-lipoic acid (ALA) supplement on brachial-ankle pulse wave velocity (baPWV),supine systolic blood pressure (SBP) and diastolic blood pressure (DBP) in overweight/obese individuals.An 8-week double-blind,randomized,placebo-controlled and cross-over trial with a 4-week washout between cross-over periods.Methods Sixty-three males and 40 females aged 22-57 years old who met the inclusion criteria as (1) Han ethnicity;(2) 20-60 years old;(3) BMI≥25 kg/m2 and having at least one of the following risk factors:borderline hypertension (130 mm Hg≤SBP＜140 mm Hg and/or 85 mm Hg≤supine DBP＜90 mm Hg),dyslipidemia(fasting total cholesterol≥5.2 mmol/L or HDL-C＜1.04 mmol/L),or impaired fasting glucose (6.1 mmol/L≤fasting glucose＜7.0 mmol/L);(4)Not on any antioxidant gender.Group 1 received 8 weeks ALA (1200 mg/day) followed by 4-week washout period and followed by another 8 weeks placebo;while Group 2 received 8 weeks placebo (1200 mg/day)followed by 4-week washout period,and followed by ALA treatment for 8 weeks.BaPWV and supine blood pressure were measured at the beginning of 1st phase and 2nd phase and at the endpoint of the whole trial.Mixed effect linear regression model was performed to compare the change of baPWV and supine blood pressure between ALA group and placebo group.Results BaPWV decreased -33.03 cm/s ± 130.70 cm/s for ALA group and increased 5.66 cm/s ± 139.89 cm/s for placebo group,supine systolic blood pressure decreased -4.09 mm Hg±9.18 mm Hg for ALA group and -2.32 mm Hg±8.16 mm Hg for placebo group.Supine diastolic blood pressure decreased -1.29 mm Hg ± 6.55 mm Hg for ALA group and -0.48 mm Hg±6.63 mm Hg for placebo group.These three mix-effect models did not show significant effect of ALA treatment after adjustment on baseline values,sex,age,treatment sequence or period.Conclusion The current trial did not provide evidence that oral intake of ALA for 8 weeks had significant effects on lowering baPWV,supine systolic blood pressure or supine diastolic blood pressure.     

老年高血压病患者大动脉扩张性的临床研究

目的 探讨老年高血压病患者大动脉扩张性的改变及其相关因素。方法 应用脉搏波传导速度(PWV)自动测量系统测定颈动脉-股动脉PWV作为反映大动脉扩张性的参数。对118例老年高血压病患者进行了PWV检测,其中男87例,女31例,年龄64-83岁,平均(67.12±10.26)岁。结果 118例老年高血压病患者的研究结果显示PWV随年龄的增大而增加(P<0 001)。多元逐步回归分析结果表明年龄、收缩压与反映大动脉扩张性的PWV关系密切(P<0.001)。结论 老年高血压病导致大动脉扩张性降低,年龄、收缩压与患者大动脉扩张性密切相关。     

Chronic coffee consumption has a detrimental effect on aortic stiffness and wave reflections

BACKGROUND: The effect of coffee consumption on the cardiovascular system is still an unresolved issue. Aortic stiffness and wave reflections are important prognosticators of cardiovascular disease risk. We have shown that caffeine acutely increases aortic stiffness and wave reflections. OBJECTIVE: The objective was to investigate the effect of chronic coffee consumption on aortic stiffness and wave reflections. DESIGN: This was a cross-sectional study of 228 healthy subjects: 141 men (x +/- SD: 41 +/- 8 y old) and 87 women (41 +/- 9 y old). Aortic stiffness was evaluated with carotid-femoral pulse wave velocity (PWV). Wave reflections were evaluated with augmentation index (AIx) and augmented pressure (AP) of the aortic pressure waveform with the use of high-fidelity pulse wave analysis. Coffee consumption was ascertained over 1 y with a food-frequency questionnaire. RESULTS: A linear relation between coffee consumption and PWV, AIx, and AP was observed (P for trend < 0.05). Compared with the nonconsumption group, PWV was on average 13% higher, AIx was 2-fold higher, and AP was 2.4-fold higher (P < 0.01 for all) in the high-consumption group (>450 mL/d). The findings remained significant after control for confounders such as age, sex, smoking habits, body mass index, total and LDL cholesterol, triacylglycerols, blood glucose, mean blood pressure, and heart rate. The linear relation (P for trend < 0.05) observed between coffee consumption and arterial pressures was largely explained when the covariates were entered in the model. CONCLUSIONS: Chronic coffee consumption exerts a detrimental effect on aortic stiffness and wave reflections, which may increase the risk of cardiovascular disease.     

545名健康中老年人大动脉脉搏波速度的测定

目的了解健康中老年人各年龄段大动脉脉搏波速度(PWV)值与性别的关系以及随年龄变化的趋势。方法按照正常人标准筛选出正常健康人545名(男395名,女150名),年龄31- 85岁,平均年龄(63．93±10．99)岁,采用脉搏波速度测定仪Complior测定颈-股动脉脉搏波速度。结果健康人群大动脉PWV平均值为(11．62±2．97)m／s。40岁以上中老年男女PWV值差异无统计学意义,30-39岁组女性PWV低于男性,无论男女PWV均与年龄正相关。根据PWV与年龄的回归方程,已获得不同年龄段PWV的正常参照值。结论健康中老年人群大动脉PWV受年龄影响较大,与性别关系不大,应按照不同年龄段建立其正常参照值。年龄与PWV的正相关,随着年龄增加,主动脉僵硬度增加,弹性下降,PWV加速。