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早期高血压弦脉脉象特点及其瞬时波强技术参数特征分析

Analysis of characteristics of early period hypertensive taut pulse and wave intensity technical parameters

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目的:应用瞬时波强(WI)技术探测早期高血压弦脉患者颈总动脉各参数,分析早期高血压弦脉的脉象特点;提取弦脉脉象判别的特征参数,探讨早期高血压弦脉患者颈总动脉WI参数的特点,以期为弦脉的精准分型及信息解读提供客观依据.方法:选择52例早期原发性高血压弦脉、50例生理性弦脉、50例平脉受试者,分析其颈总动脉的WI参数,总结早期高血压弦脉的脉象特点,并运用SIMCA 14.1统计软件提取脉象分型的主参数.结果:早期高血压弦脉组与平脉组及生理性弦脉组比较,瞬时加速度波强(W1)、负向波面积(NA)值增高,W1-W2间期降低(均P<0.01);而平脉组与生理性弦脉组W1、NA、W1-W2间期比较,差异均无统计学意义(均P>0.05).平脉组、生理性弦脉组、早期高血压弦脉组的血管压力应变弹性模量(EP)、脉搏波传导速度(PWV)、血管硬化参数(β)数值均逐渐增高(均P<0.01).平脉组血管顺应性(AC)高于其他2组(均P<0.01),生理性弦脉组AC高于早期高血压弦脉组(P<0.05).3组R-W1间期比较差异无统计学意义(P>0.05).基于主成分分析(PCA)和正交偏最小二乘法判别分析(OPLS-DA),生理性弦脉组与平脉组样本区分明显,表明2组WI各参数比较差异均有统计学意义(均P<0.05),特征性的WI参数[投影重要性(VIP值)>1]为EP、PWV、β、AC,其中贡献率为EP>PWV>β>AC.基于PCA和OPLS-DA,生理性弦脉组与早期高血压弦脉组样本区分明显,表明2组WI各参数差异均有统计学意义(均P<0.05),特征性的WI参数(VIP值>1)为EP、PWV、NA、W1、β,其中贡献率为EP>PWV>NA>W1>β.结论:区分早期高血压弦脉组与生理性弦脉组的WI特征性参数为EP、PWV、β、NA、W1.区分平脉组与生理性弦脉组特征性参数为EP、PWV、β、AC.WI技术可为脉象的精准分型和信息解读提供客观依据,值得进一步推广应用.
Objective:To analyze the pulse characteristics of early hypertension taut pulse by using wave intensity(WI)technology.To detect the parameters of common carotid artery in subjects with early hypertension taut pulse.To extract the characteristics of WI technology parameters of taut pulse in patients with early hypertension.Methods:WI parameters of 52 subjects with early primary hypertension taut pulse,50 subjects with physiological taut pulse,50 subjects with normal pulse were detected.SIMCA 14.1 statistical software was used to extract the main parameters of pulse classification in three groups.Results:Compared with the normal pulse group and the physiological taut pulse group,the W1 and NA values of the early hypertensive taut pulse group were higher,and the W1-W2 value decreased(all P<0.01),while there were no differences in W1,NA and W1-W2 values between the normal pulse group and the physiological taut pulse group(all P>0.05).From the normal pulse group to the physiologic taut pulse group to the early hypertensive taut pulse group,the values of EP,PWV,and β increased gradually(all P<0.01).AC value in the normal pulse group was higher than that in the other two groups(both P<0.01),and AC value in the physiologic taut pulse group was higher than that in the early hypertensive taut pulse group(P<0.05).R-W1 value had no difference among the three groups(P>0.05).The principal component analysis(PCA)and orthogonal projections to latent structures discriminant analysis(OPLS-DA)showed that the samples were obvious differences between the physiological taut pulse group and the normal pulse group,which indicted that WI parameters between the two groups had statistical differences(all P<0.05),and the characteristic WI parameters were EP,PWV,β and AC(VIP value>1),among which the contribution rate order was EP>PWV>β>AC.PCA and OPLS-DA showed that the samples were obvious differences between the physiological taut pulse group and the early hypertensive taut pulse group,which indicted that WI parameters between the two groups had statistical differences(all P<0.05),and the characteristic WI parameters were EP,PWV,NA,W1 and β(VIP value>1),among which the contribution rate order was EP>PWV>NA>W1>β.Conclusions:The characteristic WI parameters which can distinguish the early hypertension group and the physiological group are EP,PWV,β,NA,W1,and the characteristic WI parameters which can distinguish the normal pulse group and the physiological taut pulse group are EP,PWV,β,AC.WI technique can provide objective and reliable data basis for the information interpretation,which is worthy of further promotion.

Instantaneous wave intensity technologyPrincipal component analysisOrthogonal partial least squaresObjectification of traditional Chinese medicine

任亚娟、肖沪生、徐芳、刘萍、王艳春、马菲菲

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上海中医药大学附属龙华医院超声科,上海 200032

上海中医药大学附属龙华医院心内科,上海 200032

瞬时波强 主成分分析 正交偏最小二乘法 中医脉诊客观化

国家自然科学基金青年基金上海中医药大学附属龙华医院院级项目

81503413KY2010

2024

中国中西医结合影像学杂志
中国中西医结合学会,山东中医药大学附属医院

中国中西医结合影像学杂志

CSTPCD
影响因子:0.857
ISSN:1672-0512
年,卷(期):2024.22(1)
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