血压水平对脑血管血液动力学检测指标的影响

The Effect of Blood Pressure on Cerebral Vascular Hemodynamic Indexes

目的探讨不同血压水平对脑血管血流动力学指标(CVHI)的影响。方法在1994年开始建立的24475例卒中队列人群中,选择60～65岁的人群共2987例,分别按基线调查时的收缩压和舒张压水平分成8组,比较不同组间基线调查时检测的CVHI差异。结果脑血管平均血流速度(Vmean)、最大血流速度、最小血流速度随着收缩压和舒张压水平的升高而显著降低,Vmean减低最大幅度分别为4.62cm/s和5.74cm/s,脉搏波速、外周阻力(RV)、特异性阻抗、动态阻力、临界压水平以及舒张压与临界压的差值随着收缩压和舒张压水平的升高而显著升高,RV升高最大幅度分别为66.53kPa觹s/m和93.37kPa觹s/m。各组间CVHI的差别均有统计学意义(P<0.01)。结论收缩压和舒张压对CVHI均有显著的影响,随着血压水平的增高,CVHI异常的程度呈现渐进加重的趋势。从脑血管的血液动力学角度,理想的血压水平应不超过130/90mmHg。

Objective To probe the effect of blood pressure on cerebral vascular hemodynamic indexes （CVHI）. Methods 2 987 participants aged 60 to 65 years were selected from a stroke cohort with 24 475 populations set up in 1994, which were divided into 8 groups according to systolic and diastolic level of baseline investigation. Differences of CVHIs during baseline investigation between various blood pressure groups were compared. Results CVHIs, such as Vmean, Vmax and Vmin, were significantly deceased with both systolic and diastolic blood pressure increased. The maximal range of Vmean decreased 4.62 and 5.74 cm/s. However, indexes such as WV, RV, Zcv, DR, CP and DP were significantly increased along with systolic and diastolic blood pressure increased. The maximal range of RV increased 66.53 and 93.37kPa＊s/m. There were significant differences of CVHIs between groups （P〈0.01）.Conclusion Both systolic and diastolic blood pressure affected on CVHIs. The trend of CVHD indexes abnormality was getting severe as systolic or diastolic blood pressure elevated. In terms of cerebral vascular function, ideal blood pressure should be lower than 130/90 mm Hg.