640层容积CT评价原发性高血压患者升主动脉弹性变化的可行性和临床意义
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摘要
目的探讨利用640层容积CT评价原发性高血压患者升主动脉弹性特点的可行性。方法选取临床确诊为原发性高血压并拟行冠脉CT血管造影(CTA)检查的患者90例,设定为高血压组,按年龄分为40~<50岁、50~60岁、>60岁3组,同时选取血压正常者60例作为对照组。对原始数据0%~100%每间隔10%RR间期进行数据重建,根据软件生成的左心室收缩-舒张曲线,测量升主动脉兴趣层面管腔在收缩期与舒张期的横截面积,分析比较在不同年龄组高血压组与对照组弹性参数的差异及年龄与动脉弹性的相关性,弹性参数包括动脉扩张度(AD)、顺应性(AC)、僵硬度(β)。结果高血压组的AD、AC值低于对照组,β值明显高于对照组,差异均有统计学意义(P<0.01),年龄与动脉弹性明显相关,随着年龄的升高,两组的AD、AC值呈下降趋势,β呈明显上升趋势,且各年龄组之间弹性差异均有统计学意义(P<0.01)。结论随着年龄增长而降低,高血压患者动脉弹性的降低,预示着高血压是动脉弹性降低的重要因素。640层容积CT作为一种无创的检查方法,评价动脉弹性的可行性较好,有一定的临床价值。
Objective To explore the feasibility of using 640-slice volume CT to evaluate the elasticity of ascending aorta in patients with primary hypertension.Methods 90 patients with primary hypertension and undergoing coronary artery(CTA)were enrolled in the hypertension group,and were divided into three groups,according to the age(40-<50 years old,50-60 years old,>60 years old),and 60 normal blood pressure people were selected as the control group at the same time.Reconstructed the data from 0%to 100%of the original data at intervals of 10% of the RR interval.According to the left ventricular systolic-diastolic curve generated by the software,the vascular systolic and diastolic cross-sectional areas of the ascending aorta were measured.Compared the difference in elastic parameters and arterial elasticity between the hypertension group and the control group in different age groups,elastic parameters included arterial distensibility(AD),arterial compliance(AC),and arterial stiffness(β).Results AD and AC values in the hypertension group were lower than those in the control group,andβvalue was significantly higher than that in the control group(P<0.01).Age was significantly related to arterial elasticity,AD and AC decreased while the age increased,βshowed a significant upward trend,and the differences in elastic parameters among all the age groups were statistically significant(P<0.01).Conclusion With age increasing,arterial elasticity decreases in hypertensive patients,indicating that hypertension is an important factor in the reduction of arterial elasticity.640-slice volume CT is a non-invasive examination,it is feasible to evaluate arterial elasticity,and has clinical value.
Objective To explore the feasibility of using 640-slice volume CT to evaluate the elasticity of ascending aorta in patients with primary hypertension.Methods 90 patients with primary hypertension and undergoing coronary artery(CTA)were enrolled in the hypertension group,and were divided into three groups,according to the age(40-<50 years old,50-60 years old,>60 years old),and 60 normal blood pressure people were selected as the control group at the same time.Reconstructed the data from 0%to 100%of the original data at intervals of 10% of the RR interval.According to the left ventricular systolic-diastolic curve generated by the software,the vascular systolic and diastolic cross-sectional areas of the ascending aorta were measured.Compared the difference in elastic parameters and arterial elasticity between the hypertension group and the control group in different age groups,elastic parameters included arterial distensibility(AD),arterial compliance(AC),and arterial stiffness(β).Results AD and AC values in the hypertension group were lower than those in the control group,andβvalue was significantly higher than that in the control group(P<0.01).Age was significantly related to arterial elasticity,AD and AC decreased while the age increased,βshowed a significant upward trend,and the differences in elastic parameters among all the age groups were statistically significant(P<0.01).Conclusion With age increasing,arterial elasticity decreases in hypertensive patients,indicating that hypertension is an important factor in the reduction of arterial elasticity.640-slice volume CT is a non-invasive examination,it is feasible to evaluate arterial elasticity,and has clinical value.
引文
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[16]巢胜吾,樊济海,王丽娜,等.高血压患者升主动脉弹性与冠脉血流储备的相关性[J].心血管康复医学杂志,2016,25(2):126-129.
[17]王晓泉,李跃华,张佳胤,等.冠状动脉CT血管造影评价冠状动脉弹性的临床研究[J].疑难病杂志,2016,15(4):331-334.
[18]HO M,GOW M,BAUR L A,et al.Effect of fat loss on arterial elasticity in obese adolescents with clinical insulin resistance:RESIST study[J].Clin Endocrinol Metab,2014,99(10):1846-1853.
[19]HUSSEIN O,ZIDAN J,PLICH M,et al.Arterial elasticity in obese subjects with coronary slow flow phenomenon[J].Isr Med Assoc J,2013,15(11):753-757.
[2]梁文倩.升主动脉弹性功能的双源CT评价初步研究[D].广东:南方医科大学,2013.
[3]GANTEN M,BOESE J M,LEITERMANN D,et al.Quantification of aortic elasticity:development and experimental validation of a method usingcomputed tomography[J].Eur Radiol,2005,15(12):2506-2512.
[4]李宁,赵鹏,柳澄.双源CT评估主动脉弹性的初步研究[J].中国医学影像技术,2011,27(5):953-957.
[5]LIANG W,CHEN D,CHEN W,et al.The ascending aortic elasticity feature in normotensive subjects:evaluation coronary with CT angiography[J].Clin Imag,2014,35(5):686-692.
[6]ZHANG J,FLETCHER J G,VRTISKA T J,et al.Largevessel distensibility measurement with electrocardiographically gated multidetector CT:phantom study and initial experience[J].Radiology,2007,245(1):258-266.
[7]LI N,BECK T,CHEN J,et al.Assessment of thoracic aortic elasticity:apreliminary study using electrocardiographically gated dual-source CT[J].Eur Radiol,2011,21(7):1564-1572.
[8]VLACHOPOULOS C,AZNAOURIDIS K,STEFANADIS C,et al.Prediction of cardiovascular events and allcause mortality with arterial stiffness:a systematic review and meta-analysis[J].J Am Coll Cardiol,2010,55(13):1318-1327.
[9]NIKI K,SUGAWARA M,CHANG D,et al.A new noninvasive measurement system for intensity:evaluation of carotid wave intensity and reproducibility[J].Heart Vessel,2002,17(1):12-21.
[10]马琳,阚艳敏,张淑华,等.超声血管回声跟踪技术检测高血压患者治疗前后颈总动脉弹性的变化[J].中国全科医学,2014,17(21):2536-2542.
[11]XU L,CHEN J,YIN M,et al.Assessment of stiffness changes in the ex vivo porcine aortic wall using magnetic resonance elastography[J].Magn Reson Imag,2012,30(1):122-127.
[12]ZHANG N,CHEN J,YIN M,et al.Quantification of regional aortic stiffness using MR elastography:A phantom and ex-vivo porcine aorta study[J].Magn Reson Imaging,2016,34(2):91-96.
[13]GANTEN M,KRATTER U,VON TENGG-KOBIGK H,et al.Quantification of aortic distensibility in abdominal aortic aneurysm using ECG-Gated multi-detector computed tomography[J].Eur Radiol,2008,18(5):966-973.
[14]李亮,查云飞,杨春英,等.心电门控技术64排CT测量正常胸主动脉弹性的初步研究[J].临床放射学杂志,2011,30(3):341-344.
[15]SCHMITT M,AVOLIO A,QASEM A,et al.Basal NO locally modulates human iliac artery function in vivo[J].Hypertension,2005,46(1):227-231.
[16]巢胜吾,樊济海,王丽娜,等.高血压患者升主动脉弹性与冠脉血流储备的相关性[J].心血管康复医学杂志,2016,25(2):126-129.
[17]王晓泉,李跃华,张佳胤,等.冠状动脉CT血管造影评价冠状动脉弹性的临床研究[J].疑难病杂志,2016,15(4):331-334.
[18]HO M,GOW M,BAUR L A,et al.Effect of fat loss on arterial elasticity in obese adolescents with clinical insulin resistance:RESIST study[J].Clin Endocrinol Metab,2014,99(10):1846-1853.
[19]HUSSEIN O,ZIDAN J,PLICH M,et al.Arterial elasticity in obese subjects with coronary slow flow phenomenon[J].Isr Med Assoc J,2013,15(11):753-757.