原发性高血压脑梗死患者颈动脉粥样硬化和血管内皮功能临床研究

Study on carotid atherosclerosis and endothelium-dependent dilation in hypertensive patients with cerebral infarction

目的研究原发性高血压脑梗死患者颈动脉粥样硬化程度和血管内皮功能的临床意义。方法采用高频超声对58例无心脑血管疾病的高血压患者,36例高血压合并脑梗死及32例健康对照者,检测其颈动脉内-中膜厚度(IMT)、斑块Crouse积分、僵硬度β、Youngs'弹性指数和肱动脉内皮舒张功能(EDD%)。结果单纯高血压组和高血压脑梗死组患者颈动脉IMT和斑块Crouse积分、僵硬度β、Young's弹性指数较对照组明显增大(P<0.01),肱动脉EDD%单纯高血压组和高血压脑梗死组患者较对照组明显减低,尤以高血压脑梗死组患者改变更明显,两组比较差异具有非常显著意义(P<0.01)。结论高血压尤其并发脑梗死患者存在明显的颈动脉粥样硬化和血管内皮功能受损,高频超声检测颈动脉IMT及EDD%可作为监测高血压脑梗死患者的客观指标。

Objective To evaluate the degree of carotid atherosclerosis and endothelium - dependent ooodilation （EDD%） in hypertensive patients with cerebral infarction. Methods The carotid IMT and crouse plaque score、 arterial stiffness index β,Young＇s elastic modulus and EDD% in 58 hypertensive patients without cardiovascular or cerebrovascular disease（ simple EH group）, 36 hypertensive patients with cerebral infarction, and 32 control subjects were measured using high-frequency ultrasound. Results As compared with normal group, the IMT and crouse plaque score, and arterial stiffness index β, Young＇s elastic modulus of cerebral infarction and with simple EH group were increased significantly（ P 〈 0.01 ） , whereas compared with normal control group EDD% , the EDD% of cerebral infarction and simple EH group were reduced significant （ P 〈 0.01 ）. Conclusion The degree of carotid atherosclerosis and EDD% can provide objective indices for hypertensive patients with cerebral infarction.