高血压病患者颈动脉超声与脉压的相关性研究

The study of relationship between carotid artery ultrasound in essential hypertension and pulse pressure

目的探讨高频超声检测高血压患者颈动脉内膜-中膜厚度及斑块形成意义。方法使用美国产PHLIPS型号IUZZ高频超声对200例老年人,其中160例为高血压患者(脉压差≤45mmHg者为A组,脉压差>45mmHg者为B组),另外40例为无高血压病、冠心病、糖尿病史,无全身重大疾病史,常规检查未见异常的正常对照组(C组),观察其颈动脉的内膜-中膜厚度及斑块形成情况。结果B组其颈动脉内径、颈动脉最大内膜-中膜厚度及粥样硬化发生率明显大于A组(P<0.001),高血压病1级、2级、3级与正常对照组颈动脉内膜-中膜厚度比较均有统计学差异(P<0.05)。结论高血压可使颈动脉最大内膜-中膜厚度增加,从而引起动脉粥样硬化,而且损害随血压及脉压增高而加重,高频超声可清晰显示颈动脉内膜-中膜情况,在高血压动脉粥样硬化的预防及防治检测上有重要意义。

Objective To explore the value of high frequency ultrasound （HFUS） in detecting the intima - media thickness （IMT） and the plague development of carotid artery in essential hypertension. Methods HFUS （PHLIPS -IUZZ） examination was performed on 200 cases, including 160 cases with hypertension （group A. pulse pressure below or equal to 45 mm Hg, group B ： pulse pressure over 45 mm Hg ）. The others are the comparing group（ group C）, in which 40 cases have no history of hypertension, coronary heart disease, diabe- tes, serious disease or un -normal result of routine examination to measure the intimamedia thickness （IMT） and detect the plague development of carotid artery. Results The patients in group B had greater IMT max and lumen diameter and higher plague incidence than those in group A （ P 〈 0. 001 ）. Also, there is difference in statistics between the group with hypertension （ grade 1, 2, 3 ） and the normal group. Conclusion Hypertension might impair intima of the artery, and this process could be promoted with the aggravation of hypertension and pulse pressure. HFUS can be used to measure the IMT and observe the plague development of carotid artery. So HFUS is important for preventing the development of arteriosclerosis in hypertension .