超声检查对中年高血压患者3级分类与颈动脉粥样硬化斑块形成的相关性研究

Correlation of three grades with carotid atherosclerotic plaque by the ultrasound in middle-aged patients with hypertension

目的:探讨不同分级下中年高血压患者颈动脉粥样硬化斑块形成的相关性。方法:选取2015年1月~2016年9月心内科及神经内科门诊及住院的原发性高血压患者300例为研究对象,依据高血压分级标准分为3组,每组各100例,另选取100例血压正常体检者为对照组。所有受试者采用经颅多普勒超声(TCD)检测大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)、椎动脉1(VA1)、基底动脉(BA);采用彩色多普勒血流显像(CDFI)检测颈总动脉(CCA)、颈内动脉(ICA)、颈外动脉(ECA)、椎动脉2(VA2),分别测定舒张末期流速(EDV)、收缩期峰值流速(PSV)、搏动指数(PI)、阻力指数(RI)。采用硝酸还原酶比色法测定一氧化氮(NO)、硫代巴比妥酸法比色法测定丙二醛(MDA)、黄嘌呤氧化酶比色法测定超氧化歧化酶(SOD)。结果:高血压患者颈内动脉系血流动力学指标中PSV、EDV降低,PI、RI增加,且随血压级别的增加PSV、EDV逐渐降低,PI、RI逐斩增加;高血压患者椎动脉系血流动力学指标中PSV、EDV降低,PI、RI增加,且随血压级别的增加PSV、EDV逐渐降低,PI、RI逐斩增加。高血压患者SOD、NO低于对照组,MDA高于对照组,随着血压级别的增加,SOD、NO逐渐降低,MDA逐渐升高。结论:TCD、CDFI联合检查,可对高血压患者颅内外血管血流动力学指标进行综合评估,对颅内外动脉硬化病变的早期发现有重要意义。

Objective： To explore the correlation of different hypertension grades with carotid atherosclerotic plaque in middle-aged patients with hypertension. Methods： A total of 300 patients with primary hypertension who were admitted in the Cardiology Department and Neurology Department of our hospital from January,2015 to September,2016 were included in the study and divided into 3 groups with 100 cases in each group according to the hypertension grade criteria. Moreover,100 normal individuals who came for physical examinations were served as the control group. TCD was used to detect MCA,ACA,PCA,VA1,and BA. CDFI was used to detect CCA,ICA,ECA,and VA2. EDV,PSV,PI,and RI were detected,respectively. The nitrate reductase colorimetric method was used to detect NO,MDA,and SOD. Results： PSV and EDV in the internal carotid artery system in patients with hypertension were significantly reduced,while PI and RI were significantly increased; moreover,with the increasing of hypertension grading,PSV and EDV were gradually reduced,while PI and RI were increased. PSV and EDV in the vertebral artery system in patients with hypertension were significantly reduced,while PI and RI were significantly increased; moreover,with the increasing of hypertension grading,PSV and EDV were gradually reduced,while PI and RI were increased. SOD and NO in patients with hypertension were significantly lower than those in the control group,while MDA was significantly higher than that in the control group; moreover,with the increasing of hypertension grading,SOD and NO were gradually reduced,while MDA was gradually increased. Conclusions： TCD in combined with CDFI can make a comprehensive evaluation of hemodynamic indicators of intracranial and extracranial vessels in patients with hypertension,and is of great significance in the early detection of intracranial and extracranial arteriosclerosis.