老年高血压病患者动态脉压与颈动脉粥样硬化相关性研究

The association of ambulatory pulse pressure with carotid artery atherosclerosis in the eldly with hypertension

目的：探讨老年原发性高血压患者动态脉压与颈动脉粥样硬化间的关系。方法：根据动态全天平均脉压将95例原发性高血压患者分为两组。所有病人均经超声检测颈总动脉、颈内动脉和颈动脉分叉处的内膜中层厚度、血管内径，并计算斑块发生率。以颈总动脉最大内膜中层厚度（IMTmax）作为评价颈动脉粥样硬化程度的指标。结果：脉压〉60mmHg的患者颈总动脉内径、颈总动脉最大内膜中层厚度、颈动脉斑块发生率明显高于脉压为40～60mmHg患者（P〈0．05）。Pearson相关分析显示，平均脉压、平均收缩压及病程与颈总动脉最大内膜中层厚度呈明显正相关（r分别为0．410、0．217、0．247，P〈0．05），而平均舒张压与颈总动脉最大内膜中层厚度呈负相关（r=-0．404，P〈0．01）。结论：老年原发性高血压患者脉压差与颈动脉粥样硬化斑块和内中膜厚度相关，脉压差可能参与动脉粥样硬化的形成和发展。

Objective： To investigate the relationship between ambulatory pulse pressure （PP） and carotid artery atherosclerosis in elderly hypertensive patients. Methods： Totally ninety-five elderly patients with essential hypertension, were tested with the color Doppler ultrasounography to perform the carotid artery ultrasonic examination to measure the intima-media thickness（IMT）, lumen diameter and plaque of common carotid artery of the two sides. Maximal intima-media thickness（IMTmax） was used as the index of carotid atherosclerosis severity. Results： All the ninety-five patients were involved in the analysis of results： the IMTmax and lumen diameter in the group A （PP〉60 mmHg） were obviously higher than those in the group B （PP〈60 mmHg）, the incidence rate of carotid artery plaque was higher in group A than that in Group B. Conclusion： The pulse pressure is related to carotid artery plaque and the carotid intima-media thickness. Atherosclerosis is the cause of elevated pulse pressure, elevated pulse pressure may be involved in forming and developing of atherosclerosis.