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外周血管疾病患者的总血管阻力、增强指数和增强压增加。

Total vascular resistance, augmentation index, and augmentation pressure increase in patients with peripheral artery disease.

机构信息

Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Ultrasound Diagnostics Center, Okayama University Hospital, Okayama, Japan.

出版信息

Medicine (Baltimore). 2021 Aug 13;100(32):e26931. doi: 10.1097/MD.0000000000026931.

Abstract

Peripheral arterial disease (PAD) is one of major vascular diseases which frequently coexists with coronary arterial disease and cerebrovascular disease. The patients with PAD have a poor prognosis when it progresses. A new blood pressure testing device enables to simultaneously measure brachial blood pressure (BP), central BP, and several vascular parameters, with easy and non-invasive, in a short time. Here, we aimed to evaluate these arterial stiffness parameters in patients with PAD.In this study, 243 consecutive patients who were suspected of having PAD and referred to our hospital from September 2016 to June 2019, were registered. Several parameters, such as brachial BP, central BP, aortic pulse wave velocity (aPWV), total vascular resistance (TVR), augmentation index (AI) and augmentation pressure (AP), were determined by Mobil-O-Graph. Ankle-brachial pressure index (ABI) was used to define PAD (ABI ≤ 0.9 as PAD). The relationship between PAD and central BP, aPWV, TVR, AI, or AP were investigated.One hundred sixty-two patients (67%) were categorized as the PAD group and 81 patients (33%) as the non-PAD group. In the PAD group, the systolic brachial BP and central systolic BP were significantly higher than those in the non-PAD group (138 ± 24 mmHg vs 131 ± 19 mmHg, P < .05, 125 ± 22 mmHg vs 119 ± 18 mmHg, P < .05, respectively). TVR, AI, and AP were significantly higher in the PAD group (1785 ± 379 dyn s/cm5 vs 1661 ± 317 dyn s/cm5, P < .05, 26.2 ± 13.0% vs 22.2 ± 13.3%, P < .05, 13.5 ± 9.4 mmHg vs 10.7 ± 7.2 mmHg, P < .05, respectively). No significant differences in diastolic BP, central diastolic BP, and aPWV were found between the groups. Multivariate logistic regression analysis revealed that PAD was significantly associated with TVR, AI, and AP (P < .05, respectively).TVR/AP/AI were significantly higher in the PAD group than in the non-PAD group.

摘要

外周动脉疾病 (PAD) 是一种主要的血管疾病,常与冠状动脉疾病和脑血管疾病并存。当 PAD 进展时,患者的预后较差。一种新的血压检测设备可以同时测量肱动脉血压 (BP)、中心血压和几个血管参数,操作简单,无创,耗时短。在这里,我们旨在评估 PAD 患者的这些动脉僵硬参数。

本研究共登记了 2016 年 9 月至 2019 年 6 月因疑似 PAD 而被我院收治的 243 例连续患者。通过 Mobil-O-Graph 确定了几个参数,如肱动脉血压、中心血压、主动脉脉搏波速度 (aPWV)、总血管阻力 (TVR)、增强指数 (AI) 和增强压 (AP)。踝臂血压指数 (ABI) 用于定义 PAD(ABI≤0.9 为 PAD)。研究了 PAD 与中心血压、aPWV、TVR、AI 或 AP 的关系。

162 例患者 (67%) 被归类为 PAD 组,81 例患者 (33%) 为非 PAD 组。在 PAD 组中,收缩压肱动脉血压和中心收缩压明显高于非 PAD 组 (138±24mmHg 与 131±19mmHg,P<.05,125±22mmHg 与 119±18mmHg,P<.05)。PAD 组的 TVR、AI 和 AP 明显较高 (1785±379dyns/cm5 与 1661±317dyns/cm5,P<.05,26.2±13.0%与 22.2±13.3%,P<.05,13.5±9.4mmHg 与 10.7±7.2mmHg,P<.05)。两组间舒张压、中心舒张压和 aPWV 无显著差异。多变量 logistic 回归分析显示,PAD 与 TVR、AI 和 AP 显著相关 (P<.05,分别)。

PAD 组的 TVR/AP/AI 明显高于非 PAD 组。

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