| 张静,孙立娟.超极速脉搏波技术在代谢综合征病人动脉粥样硬化中的应用价值[J].安徽医药,2023,27(10):2081-2085. |
| 超极速脉搏波技术在代谢综合征病人动脉粥样硬化中的应用价值 |
| Application value of ultrafast pulse wave technique in Atherosclerosis of patients with metabolic syndrome |
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| DOI：10.3969/j.issn.1009-6469.2023.10.038 |
| 中文关键词: 代谢综合征 超极速脉搏波技术 颈动脉弹性 动脉粥样硬化 诊断价值 |
| 英文关键词: Metabolic syndrome Ultra-polar pulse wave technique Carotid artery elasticity Atherosclerosis Diagnostic value |
| 基金项目:秦皇岛市科学技术研究与发展计划项目( 202101A183) |
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| 中文摘要: |
| 目的探讨超极速脉搏波( ufPWV)技术在代谢综合征( MS)病人动脉粥样硬化中的应用价值。方法回顾性选取 2021年 1月至 2021年 12月秦皇岛市第四医院 MS病人 150例作为病例组，根据颈动脉内 -中膜厚度( IMT)将病例组分为 MSⅠ组: IMT正常( <1.0 mm)病人 50例； MSⅡ组: IMT增厚( 1.5 mm>IMT≥1.0 mm)病人 50例； MSⅢ组:有斑块( IMT厚度 ≥1.5 mm)病人 50例；另选取同期健康体检者 50例作为对照组。采用 ufPWV技术检测并比较四组颈动脉脉搏波指标［收缩起始时脉搏波传导速度( PWV-BS)、收缩结束时脉搏波传导速度( PWV-ES)］并采用受试者操作特征( ROC)曲线分析上述指标对动脉粥样硬化的诊断价值。结果病例组 PWV-BS、PWV-ES高于对照组(，6.85±2.14比 4.93±1.60、10.86±3.65比 6.34±2.11，均 P<0.001)； MSⅢ组 PWV-BS、PWV-ES>MSⅡ组>MSⅠ组( 8.08±1.81比 6.78±1.46比 5.69±1.24、12.80±2.39比 10.87±2.04比 8.91±1.66，均 P< 0.001)； PWV-BS、PWV-ES与身体质量指数( BMI)、舒张压( DBP)、收缩压( SBP)、总胆固醇( TC)、三酰甘油( TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖( FBG)、空腹胰岛素( FINS)呈正相关，与高密度脂蛋白胆固醇(HDL-C)呈负相关(P<0.05)； PWV-BS、 PWV-ES高水平的 MS病人发生动脉粥样硬化的风险分别是低水平病人的 2.303倍、 1.962倍， 95%CI分别为( 1.70，3.12)、(1.50，2.58)；当PWV-BS>6.20 m/s时， MS病人发生动脉粥样硬化的 AUC为 0.75；PWV-ES>10.21 m/s时，诊断 MS病人发生动脉粥样硬化的 AUC为 0.77；两者联合诊断 MS病人发生动脉粥样硬化的 AUC为 0.92，95%CI为( 0.86，0.96)灵敏度为 87.00%，特异度为86.00%，优于两者单独诊断。结论 ufPWV技术定量指标 PWV-BS、PWV-ES与 MS临床病情密切合诊断动脉粥样硬化的价值较为可靠，可为临床采取针对性防治措施提供有效指导。 |
| 英文摘要: |
| Objective To explore the application value of ultrafast pulse wave (ufPWV) technique in atherosclerosis of patients with metabolic syndrome (MS).Methods One hundred and fifty MS patients admitted to the Fourth Hospital of Qinhuangdao City from January 2021 to December 2021 were retrospectively selected as the case group, and patients in the case group were assigned into threegroups according to carotid intima-media thickness (IMT) including MS group I: 50 patients with normal IMT (<1.0 mm); MS group Ⅱ:50 patients with thickened IMT (1.5 mm > IMT ≥1.0 mm); MS group Ⅲ : 50 patients with plaque (IMT thickness≥1.5 mm) in 50 patients; another 50 cases were selected from the same period of healthy physical examination as the control group. Carotid pulse wave indices [pulse wave velocity at the onset of systole (PWV-BS) and pulse wave velocity at the end of systole (PWV-ES)] were measured andcompared among the four groups using the ufPWV technique, and the diagnostic value of these indices for atherosclerosis was analyzedusing the subject operating characteristic (ROC) curve.Results PWV-BS and PWV-ES in the experimental group were higher than those in the control group (6.85±2.14 vs. 4.93±1.60, 10.86±3.65 vs. 6.34±2.11, all P<0.001); PWV-BS and PWV-ES in MSⅢ group>MS Ⅱ group>MSⅠ group (8.08±1.81 vs. 6.78±1.46 vs. 5.69±1.24 , 12.80±2.39 vs. 10.87±2.04 vs. 8.91±1.66, all P<0.001); PWV-BS and PWV-ES were positively correlated with body mass index (BMI), diastolic blood pressure (DBP), systolic blood pressure (SBP), totalcholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), fasting insulin (FINS), and were negatively correlated with high density lipoprotein cholesterol (HDL-C) (P<0.05); the risk of atherosclerosis in MS patients with high levels of PWV-BS and PWV-ES was 2.303 and 1.962 times, respectively, which was higher than that in patients with low levels, with 95%CI of (1.70, 3.12) and (1.50, 2.58), respectively; when PWV-BS>6.20 m/s, the AUC of atherosclerosis in MS patients was 0.75; when PWV-ES >10.21 m/s, the AUC for diagnosing atherosclerosis in MS patients was 0.77; the AUC of the combined diagnosis of atherosclerosis in MS patients was 0.92, and 95%CI was (0.86, 0.96), sensitivity was 87.00% and specificity was 86.00%, which was better than both predictions alone.Conclusion The quantitative indicators of ufPWV technology, PWV-BS and PWV-ES, are closely relatedto the clinical condition of MS, and the value of joint prediction of atherosclerosis is more reliable, which can provide effective guidancefor clinical adoption of targeted prevention and control measures. |
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