老年高血压患者动态脉压、踝臂指数与颈动脉粥样硬化的关系——附72例报告

Relationship between ambulatory pulse pressure,ankle brachial index and carotid atherosclerosis in elderly patients with essential hypertension

目的:探讨老年原发性高血压(高血压)患者动态脉压、踝臂指数与颈动脉粥样硬化的关系。方法:根据动态脉压测量结果将72例老年高血压患者分为2组,A组36例,动态脉压小于60mmHg(10mmHg=1.33kPa),B组36例,动态脉压等于或大于60mm-Hg。2组患者均采用VP-1000全自动动脉硬化测定仪进行踝动脉和肱动脉血压测量,计算踝臂指数,并采用HP-5500型超声诊断仪行颈部超声检查了解颈动脉粥样硬化斑块严重程度,分析动态脉压、踝臂指数与颈动脉粥样硬化斑块的关系。结果:A组动态脉压为(50±8)mm-Hg,B组为(70±10)mmHg,A组的踝臂指数明显高于B组(P<0.05),而颈动脉粥样硬化斑块严重程度明显轻于B组(P<0.05)。直线相关分析显示,动态脉压与颈动脉粥样硬化严重程度呈正相关(r=0.49,P<0.05),踝臂指数与颈动脉粥样硬化严重程度负相关(r=-0.38,P<0.05)。结论:老年高血压患者动态脉压、踝臂指数与颈动脉粥样硬化发展相关,监测脉压和踝臂指数可早期预测动脉粥样硬化程度,尽早进行干预治疗,以减少心脑血管事件发生率。

Objective： To investigate the relationship between ambulatory pulse pressure （APP）, ankle brachial index（ABI）and carotid atherosclerosis in elderly patients with essential hypertension （EH）. Methods： Seventy-two elderly patients with EH were divided into two groups according to the APP： group A （APP 〈 60 mm- Hg, n =36）; group B（APP〉~60 mmHg, n =36）. The ankle artery pressure and brachial artery blood pressure were measured by the VP-1000 fully automated analyzer. The ABI was calculated. The serious level of carotid atherosclerosis was evaluated by using ultrasonic diagnoser（HP-5500）. The relationship between APP, ABI and carotid atheroselerotic plaque was analyzed. Results： The APP in group A was（50 ＋ 8）mmHg, and was （70 ± 10）mm- Hg in group B. ABI in group A was significantly higher than that in group B （ P 〈 0. 05 ）. The serious level of carotid plaque in group A was significantly lower than that in group B （ P 〈 0. 05 ）. Linear correlation analysis showed that APP was positively correlated with the serious level of carotid atherosclerosis （ r = 0. 49, P 〈 0. 05 ）, and ABI was negatively correlated with serious level of carotid atherosclerosis（r = -0.38 ,P 〈0.05）. Conclusion： In elderly patients with EH, both APP and ABI are related to the development of carotid atheroselerosis, and monitoring APP and ABI can predict early atherosclerosis. Early prevention and treatment of atherosclerosis can reduce the incidence of cardiovascular or cerebrovascular diseases.