原发性高血压左室肥厚患者的颈动脉结构和血流动力学特征探讨

Ultrasonographic study on structures and hemodynamic characteristic changes of carotid arteries in essential hypertension patients

目的探讨原发性高血压并左室肥厚(LVH)与非LVH患者的颈动脉结构和血流动力学改变的特点及相互关系。方法对134例受检者进行颈动脉超声研究,其中高血压病非LVH 32例,高血压并LVH 62例,正常对照组40例,分别测量各组颈部动脉总干内-中膜厚度(CCA-IMT)、分叉内-中膜厚度(B IMT)、斑块以及两侧颈总动脉、颈内动脉、椎动脉的血流动力学指标。结果①高血压组的CCA-IMT和B IMT明显高于对照组(P=0.006),其中高血压并LVH组在各组中最高;高血压非LVH组、高血压并LVH组的斑块检出率分别为30.2%、62.2%,显著高于对照组的检出率17.5%;②与对照组比较,高血压组的血流动力学指标改变表现为收缩期峰值流速、舒张末期流速及血流量降低,血管搏动指数和血管阻力指数均增高。结论原发性高血压患者的颈动脉内-中膜厚度、斑块及血流动力学改变与左室肥厚密切相关。

Objective To study the atherosclerotic structures and hemodynamic characteristic changes of carotid arteries and their interrelations in essential hypertension Patients with or without left ventricular hypertrophy （LVH） using color Doppler uhrasonography. Methods A total of 125 cases including 40 hypertension patients without LVH, 45 hypertension patients with LVH and 40 control subjects underwent color Doppler ultrasonography, Intima - media thickness （IMT） , plaque and hemodynamic indices were respectively measured in the common carotid artery （CCA） and its bifurcation （ B）, internal carotid artery and external carotid artery. Results ① The IMT of the carotid and BIMT were higher in the hypertension groups than those in the control group （ P = 0. 006）. The IMT and BIMT of hypertension patients with LVH were the highest in all groups.②Compared with the control group, there were significant hemodynamic changes in the hypertension groups. The main changes included the decrement of the peak systolic velocity （ PSV）, end diastolic velocity （ EDV）, blood flow and the increment of the pulsatility index （ PI ） and resistance index （RI）, Conclusion The LVH was correlated to the changes of CCA - IMT,plaque and hemodynernois in hypertension patients.