不同类型高血压病患者脑血管血液动力学参数指标比较

Comparison of cerebral vascular hemodynamic indexes in patients with different types of hypertensive disease

目的：通过测量高血压病患者脑血管血液动力学的指标，探讨其与脑血管血液动力学的差异。 方法：选择2004-08／2005-02在福建省级机关医院门诊就诊的原发性高血压病患者160例，男87例，女73例。按高血压的类型分为单项高血压组61例和双项高血压组99例。应用脑血管血流动力学检测仪检测平均脑血流量、平均脑血流速度、最大脑血流速度、最小脑血流速度、外周阻力，特性阻抗、脉搏波波速、动态阻力、临界压、舒张压与临界压差值。比较两组间脑血管血液动力学指标的差异。 结果：160例均进入结果分析。①脑血流量比较：左侧双项高血压组明显高于单项高血压组(9．38±2．13，8．87±1．58，P<0．05)。②最小脑血流速度比较：右侧单侧高血压组明显低于双项高血压组(7．42±2．76，8．39±2．58，P<0．05)。③左右侧双项高血压组舒张压与临界压的差值明显高于单项高血压组[左侧(2．49±094，2 11±0．66)，右侧(2．53±0．95，2．13±0．79)，P<0．05]。 结论：双项高血压组的脑血管血液动力学指标异常程度显著高于单项高血压组(除外右侧最小脑血流速度)。提示在临床工作中应加重双项 高血压病患者血压水平的调控。

AIM： To probe into the differences between indexes and cerebral vascular hemodynamics by the measurement of cerebral vascular hemodynamic indexes in patients with hypertensive disease. METHODS： 160 patients with essential hypertension, who were treated at the out-patient clinic of Fujian Provincial Institution Hospital from August 2004 to February 2005, were selected, including 87 males and 73 females. They were divided into monomial hypertension group with 61 patients and twofold hypertension group with 99 patients according to the type of hypertension. The mean cerebral blood flow （mCBF）, mean cerebral blood flow velocity （mCBFV）, maximum cerebral blood flow velocity （CBFVmax）, minimum cerebral blood flow velocity （CBFVmin）, peripheral resistance （Rv）, characteristic impedance （Zcv）, pulse wave velocity （Wv）, DR, critical pressure （CP）, difference value between diastolic pressure （DP） and CP were detected with cerebral vascular hemodynamic apparatus. The differences of cerebral vascular hemodynamic indexes were compared between the two groups. RESULTS： 160 patients were all involved in the result analysis. ① Comparison of CBF： It was higher obviously in the twofold hypertension group than that in the monomial hypertension group in the left side （9.38±2.13,8.87±1.58,P 〈 0.05）. ② Comparison of CBFVmin： It was lower obviously in the monomial hypertension group than that in the twofold hypertension group in the fight side （7.42±2.76,8.39±2.58,P 〈 0.05）. ③ The difference between DP and CP in the twofold hypertension group was significantly higher than that in the monomial hypertension group in the left and right sides [left side： （2.49±0.94,2.11 ±0.66）, right side： （2.53± 0.95,2.13±0.79）,P 〈 0.05]. CONCLUSION： The abnormality of cerebral vascular hemodynamic indexes in the twofold hypertension group is significantly higher than that in the monomial hypertension group （except CBFVmin in the right side）. It is indicated that the adjustment of blood pressure in patients with twofold hypertensive disease should be stressed in the clinical work.