北京生物醫(yī)學工程

高血壓患者與正常人的上下肢脈搏波特征差異分析

Analysis of differences in pulse wave characteristics of upper and lower limbs between hypertensive patients and normal people

作者：劉煥舒張弛劉小麗焦以飛

單位：首都醫(yī)科大學附屬北京婦產(chǎn)醫(yī)院（北京100026） 北京航空航天大學生物與醫(yī)學工程學院，北京生物醫(yī)學工程高精尖創(chuàng)新中心（北京100191） 首都醫(yī)科大學附屬北京中醫(yī)醫(yī)院（北京100010） 通信作者:張弛,E-mail: chizhang@ buaa.edu.cn； 劉小麗,E-mail： 18611780617@ ccmu. edu. cn

關(guān)鍵詞：脈搏波;高血壓;脈搏波時域特征;踝臂指數(shù);肱踝脈搏波傳導速度

分類號：R318. 04

出版年·卷·期（頁碼）：2022·41·1（24-31）

摘要：

目的通過挖掘脈搏波中蘊含的與血壓相關(guān)的特性，分析高血壓患者和正常人上下肢脈搏波的差異,以探索高血壓的前兆信息。方法分別選取20位特征明顯的高血壓患者和正常人作為受試者,采集其上下肢脈搏波信號。將脈搏波信號通過無限沖激響應(yīng)(infinite impulse response,IIR)二階低通濾波器去除高頻干擾，采用單波判別算法進行基線漂移校正，并用三次樣條插值法進行標準化歸一化處理后，選取脈搏波時域特征參數(shù)(脈搏波特征參數(shù)K、收縮期特征參數(shù)K、舒張期特征參數(shù)虬、主波寬度)、踝臂指數(shù)(ankle brachial index, ABI)和肱踝脈搏波傳導速度(brachial ankle pulse wave velocity, baPWV)作為上下肢脈搏波特征參數(shù)。最后,用SPSS25. 0軟件對數(shù)據(jù)進行t檢驗、相關(guān)性分析和主成分分析。結(jié)果高血壓組與正常組的肱踝脈搏波特征參數(shù)差異具有統(tǒng)計學意義。特征參數(shù)的相關(guān)性分析結(jié)果表明，左側(cè)和右側(cè)的脈搏波特征具有較強的相關(guān)性，左側(cè)和右側(cè)的脈搏波測量可相互替代;而上肢和下肢的脈搏波特征相關(guān)性較弱,上肢和下肢的脈搏波測量不可相互替代。釆用主成分分析法進行特征降維，分析最能表征高血壓的特征成分，并篩選出高血壓組與正常組的典型脈搏波波形圖，驗證了兩組脈搏波具有明顯特征差異。結(jié)論脈搏波傳導速度、踝臂指數(shù)及上下肢脈搏波特征參數(shù)K對血壓水平估計具有重要意義，可為無創(chuàng)血壓監(jiān)測和預(yù)防高血壓提供參考。

Objective By mining the blood pressure-related characteristics contained in the pulse wave, the difference between the upper and lower limbs of hypertensive patients and normal people is analyzed to explore the precursor information of hypertension. Methods Twenty hypertensive patients and normal people with obvious characteristics are selected as subjects, and pulse wave signals of their upper and lower limbs were collected. The pulse wave signal is passed through the infinite impulse response （IIR） second-order low-pass filter to remove high-frequency interference, the single-wave discrimination algorithm is used to correct the baseline drift, and the cubic spline interpolation method is used for standardization and normalization, and then the pulse wave time domain characteristic parameters (pulse Wave characteristic parameter K, systolic characteristic parameter K1, diastolic characteristic parameter K2, main wave width), ankle brachial index (ABI) and brachial ankle pulse wave velocity (baPWV) are used as the upper characteristic parameters of lower limb pulse wave. Finally, use SPSS25.0 software to perform t test, correlation analysis and principal component analysis on the data. Results The difference in brachial-ankle pulse wave characteristic parameters between hypertension and normal groups is statistically significant. The correlation analysis results of the characteristic parameters show that the pulse wave characteristics of the left and right sides have a strong correlation, and the pulse wave measurement of the left and right sides can replace each other; while the pulse wave characteristics of the upper and lower limbs are relatively weakly correlated. The pulse wave measurement of the lower extremities cannot be substituted for each other. The principal component analysis method is used to reduce the characteristic dimension, analyze the characteristic components that can best characterize hypertension, and screen out the typical pulse wave waveforms of the hypertension group and the normal group, verifying that the two groups of pulse waves have obvious characteristic differences. Conclusion Pulse wave velocity, ankle-brachial index, and upper and lower limb pulse wave characteristic parameters K are of great significance to the estimation of blood pressure level, and can provide references for non-invasive blood pressure monitoring and prevention of hypertension.

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