高血压与主动脉夹层的关系

The Relationship between Hypertension and Aortic Dissection

目的探讨主动脉夹层的发生与高血压的关系。方法应用多平面经食管超声心动图技术,测定19例有高血压病史主动脉夹层患者和42例单纯高血压患者的胸主动脉结构与功能的改变,并与41例正常人进行对比。结果与对照组比较,高血压组和主动脉夹层组患者胸主动脉的舒张期和收缩期内径、内膜—中膜厚度及僵硬度均明显增大(P<0.05～0.001),顺应性显著降低(P<0.01～0.001),并且随着高血压分级的增加上述变化加重(P<0.05～0.001)。与单纯性高血压组比较,主动脉夹层组患者胸主动脉舒张期和收缩期内径扩大更为明显(P<0.01),内膜—中膜厚度和僵硬度有增大的趋势(P>0.05),顺应性亦有降低趋势(P>0.05)。结论胸主动脉结构与功能的改变是主动脉夹层发生发展的病理基础,而高血压则是发生上述病理改变的始动因素。

Aim To assess the relationship between hypertension and aortic dissection. Methods The study consisted of three groups： aortic dissection group （n=19）, hypertension group （n=42） and control group （n=41）. The structure and function of thoracic aorta were evaluated by multiplane transesophageal echocardiography. Results Compared with control subjects, the systolic and diastolic diameter, intima-media thickness（IMT）, stiffness of thoracic aorta were increased and the compliance of thoracic aorta were decreased significantly （ P 〈 0. 05 -0.001 ） in patients with hypertension and aortic dissection. These changes were aggravated with increasing the grade of hypertension. The systolic and diastolic diameters of thoracic aorta were dialated significantly in patients with aortic dissection than that of in patients with hypertension （ P 〈 0.01 ）, and the intima-media thickness, compliance and sitiffness were not statistically different between two groups （ P 〉 0.05）. Conclusions structure and function of thoracic aorta are the pathological foundation of aortic dissection. The hypertension is the initial cause of these pathological changes.