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目的:探讨高血压患者外周大动脉弹性功能降低的超声诊断界值。方法:选择初次发现高血压的患者201例,按不同级别分成Ⅱ组(1级高血压,72例)、Ⅲ组(2级高血压,68例)、Ⅳ组(3级高血压,61例),选取同期门诊就诊血压正常者75例作为对照组(Ⅰ组)。应用二维超声联合ET技术检测颈、股动脉的内中膜厚度(IMT)及弹性功能参数(β,Ep,AC,PWVβ),采用ROC曲线分析找出血管弹性功能减低的超声诊断界值。结果:高血压各组颈、股动脉的IMT大于对照组,Ⅳ组颈、股动脉的IMT大于Ⅲ组和Ⅱ组,差异有统计学意义(均P<0.05)。Ⅰ、Ⅱ、Ⅲ、Ⅳ组颈、股动脉的β、Ep、PWVβ值依次升高,AC值依次降低,差异有统计学意义(均P<0.05)。颈、股动脉β、Ep、AC、PWVβ值ROC曲线下面积均>0.7,且均具有较高的灵敏度及特异度。结论:高血压患者的外周大动脉弹性明显减低;β(7.45、7.55)、Ep(95.50、98.50kPa)、AC(0.84、1.05 mm2/kPa)、PWVβ(6.15、6.15m/s)可以作为高血压患者颈、股动脉弹性减低的超声诊断界值。
Objective: To investigate the ultrasonographic cutoff value of the reduction of elastic function of peripheral artery in hypertensive patients. Methods: A total of 201 patients with primary hypertension were divided into two groups according to different grades: Grade 1 hypertension (n = 72), Group Ⅲ (Grade 2 hypertension, 68 cases), Group Ⅳ (Grade 3 hypertension, n = 61 ), Select the same period outpatient treatment of normal blood pressure in 75 cases as a control group (Ⅰ group). The IMT and elastic function parameters (β, Ep, AC, PWVβ) of the neck and femoral artery were detected by two-dimensional ultrasonography combined with ET. The cut-off value of ultrasonic diagnosis was calculated by ROC curve analysis. Results: The IMT of neck and femoral artery in hypertension group were higher than that in control group. The IMT of neck and femoral artery in group Ⅳ was higher than that of group Ⅲ and Ⅱ (all P <0.05). In group Ⅰ, Ⅱ, Ⅲ and Ⅳ, the values of β, Ep and PWVβ in the cervical and femoral arteries increased successively and the AC values decreased in turn, with statistical significance (all P <0.05). The area under the ROC curve of the β, Ep, AC, PWVβ values of the neck and femoral artery were all> 0.7, and both had higher sensitivity and specificity. Conclusions: The elasticity of peripheral arteries in hypertensive patients was significantly decreased. The levels of β (7.45,7.55), Ep (95.50,98.50kPa), AC (0.84,1.05 mm2 / kPa), PWVβ (6.15,6.15m / s) Ultrasonographic cutoff in patients with reduced neck and femoral artery elasticity.