老年高血压患者脑血流动力学研究

Study of Hemodynamics in Senile Patients With Hypertension

目的:探讨老年高血压患者颅内动脉血流动力学变化规律。方法:高血压组68例根据高血压病程长短分为Ⅰ组(病程10年以下)38例和Ⅱ组(病程≥10年)30例,对照组40例为同期体检无高血压、高血糖、高血脂及心脑血管病史者。采用经颅多普勒超声(TCD)检测颅内动脉血流动力学的变化,比较高血压各组与对照组异常频谱形态及收缩峰流速异常检出率,颅内动脉平均流速(Vm)及搏动指数(PI)变化。结果:高血压组与对照组比较,PI值增高、频谱异常率增高(P<0.05),收缩峰流速异常率增高(P<0.01),Vm差异无显著性(P>0.05);高血压Ⅰ组和Ⅱ组比较,收缩峰流速异常率差异有极显著性(P<0.01),Vm、PI值、频谱异常率差异无显著性(P>0.05)。结论:TCD检查显示高血压患者脑血流动力学有明显异常,提示TCD检查对预防老年高血压患者并发脑血管意外有一定临床意义。

Objective:To study the changes of hemodynamics in senile patients with hypertension.Methods:The subjects were 68 patients,who were diagnosed as hypertension (hyperglycosemia and hyperlipidemia were excluded) by routine examine. The patients were subdivided into two groups: patients with hypertension for less than 10 years (group Ⅰ,n=38) and patients with hypertension for more than 10 years (group Ⅱ,n=30). The control group were those who have no hypertension,no hyperglycosemia or hyperlipidemia,by the same examination, nor history of cardiac or cerebral diseases. Transcranial Doppler(TCD) was used to find out intracranial hemodynamic change and character of blood wave. The abnormal spectrum and the rate of abnormal systolic peak speed were compared among the groups. Mean velocity of intracranial arteries (Vm) and pulse index (PI) of all the patients were recorded. Results:There was no difference in Vm between the hypertension groups and the control group. Whereas there was significant difference in PI increment and the rate of abnormal spectrum (P<0.05). Further,there was very significant difference in the rate of abnormal systolic peek speed (P<0.001). Between the hypertension group I and hypertension group II,there was very significant difference in the rate of abnormal systolic peek speed(P<0.001).But no difference was found in Vm,PI and the rate of abnormal spectrum between the two hypertension groups. Conclusion:TCD examination has demonstrated that cerebral hemodynamic status is abnormal in patients with hypertension,which suggests that TCD is of great importance in the prevention of cerebral vascular accidents in patients with hypertension.