摘要
目的:探讨实时剪切波弹性成像(SWE)和彩色脉搏波成像(UFPWV)技术评估痛风性关节炎(GA)患者颈动脉硬度的应用价值.方法:选择2022年8月至2023年7月期间宜宾市第一人民医院收治的80例GA患者纳入GA组,其中24例经影像学检查确诊合并骨质侵蚀,56例未合并骨质侵蚀;另选取同期在本院进行健康体检的40名健康者纳入健康对照组.采用SWE和UFPWV技术检测所有受检者颈总动脉血管壁杨氏模量最大(Max)、最小(Min)及平均(Mean)值,以及收缩期开始时的脉搏波速度(PWVBS)和收缩期结束时的脉搏波速度(PWVES),评估颈总动脉血管壁纵向和环向血管壁硬度.比较两组杨氏模量值、PWVBS和PWVES差异,分析GA患者合并骨质侵蚀与杨氏模量值、PWVBS和PWVES的相关性.结果:GA组杨氏模量Max值(78.80±12.38)kPa、Min值(57.83±7.42)kPa、Mean值(67.67±8.38)kPa,以及PWVBS(7.06±0.59)m/s和PWVES(9.50±0.63)m/s均显著大于健康对照组,差异有统计学意义(t=11.066、8.216、11.751、14.159、19.118,P＜0.05).合并骨质侵蚀GA患者杨氏模量Max值(82.95±6.37)kPa、Min值(59.59±5.29)kPa、Mean值(72.18±7.62)kPa,以及PWVBS(7.37±0.43)m/s和PWVES(10.43±0.47)m/s均显著大于未合并骨质侵蚀患者[(77.01±5.32)kPa、(57.08±4.73)kPa、(65.73±4.54)kPa和(6.92±0.39)m/s、(9.10±0.41)m/s,t=4.309、2.099、4.699、4.586、12.720,P＜0.05].Spearman相关性分析显示,GA患者杨氏模量Max、Min及Mean值,以及PWVBS和PWVES与合并骨质侵蚀具有显著相关性(r=0.602、0.421、0.682、0.647、0.732,P＜0.05).结论:SWE和UFPWV技术可以评价GA患者血管壁硬度,GA患者颈总动脉血管壁的纵向及环向硬度高于健康人,合并骨质侵蚀的GA患者颈总动脉血管壁的纵向及环向硬度更高.
Abstract
Objective:To explore the application value of real-time shear wave elastography(SWE)and ultrafast pulse wave velocity(UFPWV)techniques in assessing carotid artery stiffness of patients with gouty arthritis(GA).Methods:A total of 80 GA patients admitted to the First People's Hospital of Yibin from August 2022 to July 2023 were selected as GA group.Among of them,24 cases combined with bone erosion who were confirmed by imaging examination,and 56 cases did not combine with bone erosion.In addition,a total of 40 healthy individuals,who underwent physical examinations in our hospital during the same period,were selected as the healthy control group.SWE and UFPWV were used to detect the maximum,minimum and mean values of Young's modulus values of the vessel wall of common carotid artery,and the pulse wave velocity at the beginning of systole(PWVBS)and pulse wave velocity at the end of systole(PWVES)of the vessel wall of common carotid artery of all subjects,and to assess the hardness of circumferential and longitudinal vessel wall of common carotid artery of them.The differences in Young's modulus values,PWVBS and PWVES between two groups were compared.And then,the correlations between bone erosion and Young's modulus values,PWVBS,PWVES of GA patients were further analyzed.Results:The maximum,minimum,mean values,PWVBS and PWVES in the GA group were respectively(78.80±12.38)kPa,(57.83±7.42)kPa,(67.67±8.38)kPa,(7.06±0.59)m/s and(9.50±0.63)m/s,which were significantly higher than those in the healthy control group(t=11.066,8.216,11.751,14.159,19.118,P＜0.05).The maximum,minimum,mean values,PWVBS and PWVES of GA patients with bone erosion were respectively(82.95±6.37)kPa,(59.59±5.29)kPa,(72.18±7.62)kPa,(7.37±0.43)m/s,(10.43±0.47)m/s,which were significantly higher than those[(77.01±5.32)kPa,(57.08±4.73)kPa,(65.73±4.54)kPa,(6.92±0.39)m/s and(9.10±0.41)m/s]of GA patients without bone erosion,the differences were significant(t=4.309,2.099,4.699,4.586,12.720,P＜0.05).Spearman correlation analysis showed that there was significant correlations between maximum,minimum,mean values,PWVBS,PWVES and the combined bone erosion in GA patients(r=0.602,0.421,0.682,0.647,0.732,P＜0.05).Conclusion:SWE and UFPEV techniques can evaluate the hardness of vascular wall of GA patients,and the hardness of circumferential and longitudinal vessel wall of common carotid artery of GA patient is higher than that of healthy person,and the hardness of circumferential and longitudinal vessel wall of common carotid artery of GA patient with bone erosion is higher.
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