河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (3): 261-266.doi: 10.3969/j.issn.1007-3205.2025.03.003

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颈动脉脉搏波速度评估高血压肾病患者肾损伤的应用价值

  

  1. 1.河北医科大学第三医院超声科，河北 石家庄 050051；2.河北医科大学第三医院肾内科，河北 石家庄  050051

  • 出版日期:2025-03-25 发布日期:2025-03-26
  • 作者简介:王赟（1986-），女，河北石家庄人，河北医科大学第三医院主治医师，医学硕士，从事实体器官超声介入研究。

  • 基金资助:
    河北省医学科学研究课题计划（20230714）

Application value of carotid artery pulse wave velocity in assessing renal damage in patients with hypertensive nephropathy


  1. 1.Department of Ultrasound, the Third Hospital of Hebei Medical University, Shijiazhuang 
    050051, China; 2.Department of Nephrology, the Third Hospital of Hebei Medical 
    University, Shijiazhuang 050051, China


  • Online:2025-03-25 Published:2025-03-26

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摘要： 目的 探讨脉搏波速度(pulse wave velocity,PWV)在评估高血压肾病患者肾功能不全中的应用潜力。
方法 选取慢性高血压肾病患者60例、无肾损害高血压患者60例及健康对照体检者30例的临床数据。收集的人口统计学特征和实验室指标，包括血压、空腹血糖(fasting plasma glucose,FPG)、三酰甘油(triglycerides,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)等参数，通过UFI超声技术测定的颈动脉搏动波速度（BS-PWV和ES-PWV），并比较不同组别之间的差异性。
结果 高血压组、高血压肾损伤组的SBP、DBP、FPG、TG、TC、LDL-C均高于健康对照组，HDL-C低于健康对照组（P＜0.05），高血压组与高血压肾损伤组的SBP、DBP、FPG、TG、TC、LDL-C及HDL-C比较差异无统计学意义（P＞0.05）。健康对照组与高血压组肾脏滤过率比较差异无统计学意义（P＜0.05），高血压肾损伤组肾脏滤过率高于健康对照组与高血压组（P＜0.05）。高血压组、高血压肾损伤组BS-PWV、ES-PWV均高于健康对照组，高血压肾损伤组BS-PWV、ES-PWV均高于高血压组（P＜0.05）。Pearson相关性分析结果显示随着肾小球滤过率的降低，BS-PWV和ES-PWV逐渐升高（P＜0.001）。
结论 PWV作为无创性诊断指标，其与肾小球滤过率的关联性显著，在监测和预测高血压患者肾脏损害、尤其是对高血压肾病的预防方面，PWV表现出显著的临床相关性。


关键词: 肾功能不全, 高血压, 颈动脉脉搏波, 肾小球滤过率

Abstract: Objective To explore the application potential of pulse wave velocity (PWV) measurement in evaluating renal dysfunction in patients with hypertensive nephropathy (HN). 
Methods Clinical data of 60 patients with chronic HN, 60 patients with hypertension but without kidney damage, and 30 healthy control subjects who underwent physical examinations were selected. The demographic characteristics and laboratory indicators, including blood pressure, fast plasma glucose (FPG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and other parameters, were collected. UFI ultrasound technology was used to determine carotid PWV ［beginning of systole PWV (BS-PWV) and end of systole PWV (ES-PWV)］, and the differences between different groups were compared. 
Results The SBP, DBP, FPG, TG, TC, and LDL-C of the hypertension group and hypertensive kidney injury group were higher than those of the healthy control group, while HDL-C was lower than that of the healthy control group (P＜0.05). There was no significant difference in SBP, DBP, FPG, TG, TC, LDL-C, and HDL-C between the hypertension group and hypertensive kidney injury group (P＞0.05). There was no significant difference in renal filtration rate between the healthy control group and the hypertension group (P＜0.05), while the renal filtration rate in the hypertensive kidney injury group was higher than that in the healthy control group and the hypertension group (P＜0.05). The BS-PWV and ES-PWV were higher in the hypertension group and hypertensive kidney injury group than in the healthy control group, and higher in the hypertensive kidney injury group than in the hypertension group (P＜0.05). The Pearson correlation analysis results showed that as the glomerular filtration rate decreased, BS-PWV and ES-PWV gradually increased (P＜0.001). 
Conclusion PWV serves as a non-invasive diagnostic indicator, demonstrating a strong association with glomerular filtration rate. Its clinical implications in monitoring and predicting renal damage in hypertensive individuals, particularly in the prevention of HN, are found to be substantial. 


Key words: renal dysfunction, hypertension, carotid pulse wave, glomerular filtration rate

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