摘要
目的 使用ROC曲线法结合超声射频信号动脉弹性分析技术（QAS）评价高血压患者心脏结构与功能和动脉弹性改变的敏感指标,明确各指标的诊断临界点,初步探讨其诊断高血压患者心血管改变的应用价值.方法 2008年10月至2009年11月,卫生部北京医院超声科监测高血压组（167例）与对照组（165例）患者的心脏结构功能和颈动脉弹性参数,并进行两组间比较.对各指标绘制ROC曲线并获得界值.结果 高血压组室间隔厚度（mm）、左室后壁厚度（mm）、E/e、Tei指数高于对照组（9.8±1.7 vs 7.9±1.0,9.7±1.6 vs 7.8±0.8,10.9±3.1 vs 7.7±1.6,0.58±0.13 vs 0.45±0.09）,差异均有统计学意义（均P〈0.05）;高血压组血管弹性参数PWVβ（m/s）和β高于对照组（7.8±1.6 vs 5.8±1.3,11.0±5.2 vs 7.5±3.0）,差异均有统计学意义（均P〈0.05）.ROC评价显示室间隔厚度、左室后壁厚度、E/e、Tei指数、PWVβ和β值的ROC曲线下面积分别为0.808、0.843、0.816、0.827、0.779、0.632.对应界值分别为8.710、8.210、9.230、0.425、6.700和8.750.鉴别高血压心血管改变的敏感性和特异性分别为78.6%和78.9%、82.1%和84.2%、67.9%和89.5%、100%和52.6%、82.1%和68.4%、57.1%和63.2%.结论 高血压引起动脉僵硬度增高,心功能障碍;动脉硬化是早期心功能障碍的＂窗口＂.
Objective To apply the receiver operating characteristic（ROC） carves and QAS technology in exploring sensitive and feasible indices about the structure and function of heart and arterial stiffness so as to determine the optimal operating point （OOP） and evaluate its value of cardiovascular changes in hypertensive patients.Methotis The parameters of arterial stiffness and heart function were measured and calculated in hypertensive patients（n=167）and control（n=165）.The results were compared and critical values obtained by receiver operating characteristic （ROC） curves.Results Interventricular septal thickness,posterior wall thickness of left ventricle,E/e and Tei of hypertensive group were significantly higher than those of control group（P〈0.05）.In hypertensive group,the parameters of arterial stiffness including β,and PWVβ were significantly higher than those of control group（P〈0.05）.The areas of under the ROC curves were 0.808,0.843,0.816,0.827,0.779 and 0.632.The sensitivity and specificity of detecting the cardiovascular changes of hypertension for interventricular septal thickness,posterior wall thickness of left ventricle,E/e,Tei,PWVβ and βWere 78.6%/78.9%,82.1%/84.2%.67.9%/89.5%,100%/52.6%,82.1%/68.4% and 57.1%/63.2% respectively.Conclusion The arterial stiffness and heart dysfunction may result from hypertension.Arterial stiffness can be one of monitoring indices in early-stage damage of heart function.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2010年第23期1602-1605,共4页
National Medical Journal of China
