北京生物医学工程

高血压患者与正常人的上下肢脉搏波特征差异分析

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

作者：刘焕舒张弛刘小丽焦以飞

单位：首都医科大学附属北京妇产医院（北京100026） 北京航空航天大学生物与医学工程学院，北京生物医学工程高精尖创新中心（北京100191） 首都医科大学附属北京中医医院（北京100010） 通信作者:张弛,E-mail: chizhang@ buaa.edu.cn； 刘小丽,E-mail： 18611780617@ ccmu. edu. cn

关键词：脉搏波;高血压;脉搏波时域特征;踝臂指数;肱踝脉搏波传导速度

分类号：R318. 04

出版年·卷·期（页码）：2022·41·1（24-31）

摘要：

目的通过挖掘脉搏波中蕴含的与血压相关的特性，分析高血压患者和正常人上下肢脉搏波的差异,以探索高血压的前兆信息。方法分别选取20位特征明显的高血压患者和正常人作为受试者,采集其上下肢脉搏波信号。将脉搏波信号通过无限冲激响应(infinite impulse response,IIR)二阶低通滤波器去除高频干扰，采用单波判别算法进行基线漂移校正，并用三次样条插值法进行标准化归一化处理后，选取脉搏波时域特征参数(脉搏波特征参数K、收缩期特征参数K、舒张期特征参数虬、主波宽度)、踝臂指数(ankle brachial index, ABI)和肱踝脉搏波传导速度(brachial ankle pulse wave velocity, baPWV)作为上下肢脉搏波特征参数。最后,用SPSS25. 0软件对数据进行t检验、相关性分析和主成分分析。结果高血压组与正常组的肱踝脉搏波特征参数差异具有统计学意义。特征参数的相关性分析结果表明，左侧和右侧的脉搏波特征具有较强的相关性，左侧和右侧的脉搏波测量可相互替代;而上肢和下肢的脉搏波特征相关性较弱,上肢和下肢的脉搏波测量不可相互替代。釆用主成分分析法进行特征降维，分析最能表征高血压的特征成分，并筛选出高血压组与正常组的典型脉搏波波形图，验证了两组脉搏波具有明显特征差异。结论脉搏波传导速度、踝臂指数及上下肢脉搏波特征参数K对血压水平估计具有重要意义，可为无创血压监测和预防高血压提供参考。

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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