動脈硬度和兩種非侵入量測方法之簡介－技術報告

Introduction to Arterial Stiffness and Two Noninvasive Measurement Devices-A Technical Report

蔡忠憲(Chung-Hsien Tsai) ； 陳慈安(Cih-An Chen) ； 吳英黛(Ying-Tai Wu)

《物理治療》 31卷5期 (2006/10) Pp. 316-324

摘要

背景：動脈硬化疾病有很高的盛行率，可利用非侵入性方式偵測患者的血管硬化程度，來執行篩檢與量化介入的成效。目的：簡介兩種市售之測量儀器－脈波速率儀與指容脈波儀，討論其原理、操作、信效度及產生測量差異的因素，前者量測脈波速率，脈波速率受血管壁特質、自主神經、血流狀態影響，反映血管的順應性，主要以體表預估的動脈距離，除以兩處動脈脈波的時間差所得的速率呈現；後者量測指容積脈波，同樣可以作為全身動脈順應性的代表，主要以硬度指數(stiffness index)與反射指數(reflection index)兩種方式呈現。兩者對於正常人與動脈硬化患者的測量值均具有良好的信度與效度，相關係數均在0.8以上。討論：兩種測量方式在施行時有一些影響因素，儀器本身如鬆脫、龜裂、漏氣、故障等，除儀器本身的因素外，因受試者的年齡、性別、疾病、危險因子、姿勢、動作、自主神經活性、藥物、運動、睡眠、以及血管之病生理狀態有所差異。結論：動脈硬度是心血管疾病的重要指標，非侵入性、操作簡單且有良好信效度的脈波速率與指容積脈波可提供臨床工作者偵測患者動脈硬度，有助於早期篩檢、預防心血管事件發生，並監測治療介入的成效。

關鍵字

動脈硬化 ； 順應性 ； 脈波速率 ； 指容積脈波

並列摘要

Background: Arterial stiffness has high prevalence in modern society. There is a demand for reliable and valid noninvasive measurements to do the screening and quantify the improvements after intervention. Purpose: The purpose of this report was to introduce the two commercially available devices that can measure pulse wave velocity (PWV) and digital volume pulse (DVP) to reflect arterial stiffness. The principle of measurements, operational method, the study results of the reliability and validity, and the factors that may contribute to the variability were described and discussed. PWV is presented by estimated distance on body surface divided into transit time between two pulses. It is influenced by properties of arterial wall, autonomic nervous excitation, and the condition of blood flow, which reflect the arterial compliance. DVP is another noninvasive way to estimate the arterial compliance by computing stiffness index and reflection index that can be influenced by the similar factors as PWV. Discussion: Both of the two measurements have been reported to have good reliability (r=0.87-0.98, ICC=0.636) and can be a valid measure to present central arterial stiffness. Measurement errors, such as loose cuffs, chap tubes, air leaking, should be avoided. Subject characteristics, like age, gender, diseases, risk factors, posture, movements, autonomic nervous excitation, drug usage, exercise habits, sleep condition, and vessel conditions all influence the measurements. Conclusion: Noninvasive, simply operated, reliable and valid PWV and DVP can be used in clinics to detect the arterial stiffness. It is helpful for physical therapists to do early screening to prevent cardiovascular events and to monitor the effects of therapeutic interventions.

並列關鍵字

Arterial stiffness ； Compliance ； Pulse wave velocity ； Digital volume pulse