Sugawara H, Kubota I, Tomoike H
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
Angiology. 1998 Jan;49(1):25-31. doi: 10.1177/000331979804900103.
Blood flow velocity of the brachial artery was measured noninvasively by ultrasound pulsed Doppler technique under the guidance of a B-mode ultrasound image in 56 patients with angina pectoris. There was no significant stenosis along the brachial artery on a B-mode image. The authors investigated seven clinical backgrounds for each patient, ie, age, gender, absence or presence of smoking, hyperlipidemia, diabetes mellitus, hypertension, and the number of significantly stenosed (> or =50%) coronary arteries. Among these variables, the determinants of the brachial artery velocity profile were selected by stepwise multiple regression analysis. Selected variables were the presence of hypertension for peak systolic velocity (R=0.276), age and the number of diseased vessels for peak reverse velocity (R=0.624), and age for peak diastolic velocity (R=0.609). The peak systolic velocity was larger in patients with hypertension than in those without it (0.565+/-0.023 vs 0.490+/-0.013 m/see, P<0.05), and the peak reverse velocity was larger in patients with multivessel disease than those without it (-0.117+/-0.071 vs -0.053+/-0.081 m/sec, P<0.01). Thus, the level of flow velocity of the brachial artery in patients with angina pectoris was partly determined by age, hypertension, and severity of coronary artery disease. The simple measurement of brachial artery flow velocity suggests changes in peripheral vasculature related to atherosclerosis.
在B型超声图像引导下,采用超声脉冲多普勒技术对56例心绞痛患者的肱动脉血流速度进行无创测量。B型图像显示肱动脉全程无明显狭窄。作者调查了每位患者的七个临床背景,即年龄、性别、有无吸烟、高脂血症、糖尿病、高血压以及冠状动脉显著狭窄(≥50%)的数量。在这些变量中,通过逐步多元回归分析选择肱动脉速度剖面的决定因素。选择的变量为:收缩期峰值速度的高血压存在情况(R = 0.276)、舒张期峰值速度的年龄(R = 0.609)以及反向峰值速度的年龄和病变血管数量(R = 0.624)。高血压患者的收缩期峰值速度高于无高血压患者(0.565±0.023 vs 0.490±0.013 m/sec,P<0.05),多支血管病变患者的反向峰值速度高于无病变患者(-0.117±0.071 vs -0.053±0.081 m/sec,P<0.01)。因此,心绞痛患者肱动脉血流速度水平部分由年龄、高血压和冠状动脉疾病严重程度决定。肱动脉血流速度的简单测量提示了与动脉粥样硬化相关的外周血管变化。