老老年人高血压与颈动脉顺应性的关系

Correlative control study about carotid artery complaisance in hypertension patients 80 years of age or older

目的研究≥80岁以上老老年人高血压与颈动脉顺应性的关系,为治疗高血压和预防动脉硬化提供依据。方法参照动脉粥样硬化社区研究(ARIC)动脉硬度指标测试方案,对49例≥80岁以上高血压患者(其中25例为单纯性收缩期高血压组,另24例为收缩和舒张期均增高的高血压患者)进行高分辨率颈动脉超声检查,测量颈动脉收缩期和舒张期内径,并计算颈动脉紧张度、扩张性和僵硬度,与20例血压正常对照组进行3组之间差异性比较及相关因素分析。结果颈动脉紧张度在正常对照组、收缩/舒张期高血压组、单纯收缩期高血压组3组之间差异有统计学意义(P<0.05)。颈动脉扩张性和颈动脉僵硬度在单纯收缩期高血压组与正常对照组、收缩/舒张期高血压组间差异有统计学意义(P<0.01),而正常对照组与收缩/舒张期高血压组间差异无统计学意义(P>0.05)。结论≥80岁以上老老年人单纯性收缩期高血压患者颈动脉僵硬度增加,颈动脉扩张性降低,临床上应重点关注对单纯性收缩期高血压患者的检查和治疗。

Objective To prevent arteriosclerosis and treat hypertension, the relationship was studied between carotid complaisance and hypertension of patients who were 80 years of age or older. Methods According to the Atherosclerosis Risk in Communities（ARIC） study, 49 patients with hypertension who were 80 years of age or older were randomly enrolled （25 cases of isolated systolic hypertension, 24 cases of systolic and diastolic phase hypertension）. The carotid diameter and carotid complaisance were measured, including arterial strain（AS）, arterial distensibility（AD） and arterial stiffness（ASt） with high resolution ultrasonography, and matching control group（20 normal persons）. Results As among three groups had significant difference （ P 〈 0.05）, AD in isolated systolic hypertension group was lower than that in others, ASt in isolated systolic hypertension group was higher than that in others（ P 〈 0.01）. Difference between systolic and diastolic phase hypertension group and control group were not significant. Conclusion ASt increases and AD decreases in isolated systolic hypertension patients who are 80 years of age or older. More emphasis should pay to cure and check the patients of isolated systolic hypertension.