高血压病患者脉压与颈动脉顺应性及心室肥厚的关系

The association of pulse pressure with the compliance of carotid artery and ventricular hypertrophy in hypertension patients

目的探讨高血压患者脉压(PP)与颈动脉顺应性和左心室肥厚之间的关系。方法87例高血压病患者分为PP≤40mmHg组(PP1)25例,40mmHg<PP≤60mmHg组(PP2)33例和PP>60mmHg组(PP3)29例,应用超声检测颈动脉及心脏各指标。结果PP3组与PP1、PP2组比较,颈动脉紧张度与扩张性明显降低,而僵硬度明显增高。PP3组较PP1和PP2组左室肥厚发生率明显增加。主动脉根部内径(AO)、左室内径(LA)、舒张末期室间隔厚度(IVST)、左心室重量(LVM)与颈动脉紧张度呈负相关,而与颈动脉僵硬度呈正相关。结论高血压患者PP与颈动脉顺应性密切相关。PP升高,颈动脉顺应性降低,心肌肥厚的发生率增加。

Objective To investigate the association of pulse pressure with the compliance of carotid artery and hypertension patients with left ventricular hypertrophy. Methods Eighty-seven cases patients with essential hypertension were divided into three group according to pulse pressure [pp≤40 mm Hg（ppl group,25 cases）, 40 mm Hg〈PP≤60 mm Hg（pp2 group,33 cases） and PP〉60 mm Hg（pp3 group,29 cases）]. Ultrasonography was performed to detect the parameter of carotid artery and cardiac structure. Results Compared with PP1 group and PP2 group, PP3 group showed higher levels of carotid stiffness, and carotid strain and carotid distensibility were lower significantly. The incidence of left ventricular hypertrophy in PP3 increased significantly than PPland PP2. AO,LA,IVS,LVM were negatively correlated to carotid strain, and positively correlated to carotid stiffness. Conclusion The carotid compliance is closely correlated with the pulse pressure in senile essential hypertensives. With the higher pulse pressure and the lower carotid compliance, the incidence of left ventricular hypertrophy is increased.