高血压微循环与体循环动力学临床研究系列(下) ——Ⅴ.高血压病血流动力学异常与微循环障碍

Clinical Studies on Correlation of Microcirculation and Systemic Circulation of Hypertension(Part Ⅱ) Microcirculatory Disturbance and Abnormal Hernodynamics in Hypertensive Patients

本文对原发性高血压(EH)病人30例,正常人30例。观察其外周“压降”发生部位及其上下游血流动力学变化。结果显示:1.EH组外周血压显著下降部位发生于小动脉和微动脉,而正常对照组外周血压显著下降部位仅发生于毛细血管前微动脉,提示EH组总外周阻力血管段延长。2.EH组上游血流动力学异常表现为:(1)动脉血压升高,总外周阻力(TPR)和室壁应力(ESS)等后负荷增加引起左室肥厚(LVH)和舒张功能障碍;(2)动脉顺应性减退,壁剪切应力下降,壁张力增加和壁/腔比率增大。3.EH组微循环障碍表现:微血管压、流、阻异常,微循环储备功能减退,微血管病,加权积分值增加等。

The hemodynamic changes of the macro and microcirculation were observed in 30 patients with essential hypertension (EH) and 30 normal control. The results showed that there was a peripheral arteral pressure falls rapidly in the small arteries and arterioles, which were the main site of peripheral resistance against which the heart pumps in EH. but the pressure falls rapidly in the arterioles in normal group. The abnormal hemodynamics and its effects in EH: There were left ventricular hypertrophy with failed diastolic function during increased afterload (BP、TPR、ESS). A thicking wall of arteries, atherosclerosis and dilating or dissecting aneurysm may be presented by effects of a decreased shear stress and increased wall tesion. The microcirculatory disturbances in EH: Abnormal blood pressure, flux and resistance in microciTculatory levels and significantly arose integral value of the microangiopathies in the nailfold and the bulbar conjunctivas.