老年单纯收缩期高血压患者动脉僵硬度的临床研究

Artery stiffness in elderly patients with isolated systolic hypertension

目的探讨老年单纯收缩期高血压患者动脉僵硬度的改变。方法应用脉搏波速度自动分析仪测定颈动脉-股动脉脉搏波速度(CFPWV)和颈动脉-桡动脉脉搏波速度(CRPWV)分别作为评估中央弹性大动脉和外周中等肌性动脉僵硬度的指标,对43例健康老年人:男24例,女19例,年龄60～79岁,平均(68.2±4.6)岁和87例(单纯收缩期高血压患者40例,非单纯收缩期高血压患者47例)老年高血压患者:男41例,女46例,年龄60～78岁,平均(68.1±5.2)岁,进行脉搏波速度检测。结果老年单纯收缩期高血压患者CFPWV显著高于非单纯收缩期高血压及正常血压者(均P<0.01),CRPWV在3组间无显著差异(P>0.05);CFPWV与脉压(r=0.229,P=0.009)及年龄(r=0.203,P=0.020)呈显著正相关,CRPWV与脉压及年龄无显著相关性(均P>0.05)。多元逐步回归分析显示,脉压是CFPWV最主要的影响因素。结论老年单纯收缩期高血压患者大动脉僵硬度明显升高。

Objective To explore the change of arterial stiffness in elderly patients with isolated systolic hypertension. Methods Carotid-femoral pulse wave velocity （CFPWV） and carotid-radial pulse wave velocity （CRPWV） as the parameters reflecting central elastic large arterial and peripheral medium-sized muscular arterial stiffness respectively were measured by automatic pulse wave velocity measuring system. Forty-three healthy elderly subjects （24 males and 19 females, aged 60～79 years） and 87 elderly hypertensive patients 441 males and 46 females, aged 60～78 years, including 40 isolated systolic hypertensive（ISH） patients and 47 non-isolated systolic hypertensive （NISH） patients3 were enrolled in the study. Results CFPWV was higher in ISH group than in NISH group or normal control group （both P〈0.01）, whereas CRPWV was not different significantly among the 3 groups. CFPWV was positively and significantly correlated with pulse pressure（r= 0. 229, P= 0. 009）and age（ r= 0. 203, P = 0. 020）. Such correlation was not observed with CRPWV. Stepwise multiple regression analysis demonstrated that CFPWV correlated independently with pulse pressure. Conclusion Central elastic large arterial stiffness increased significantly in elderly patients with isolated systolic hypertension.