ET技术监测非洛地平对高血压患者动脉弹性功能变化的研究

Changes in arterial elasticity of patients with hypertension after felodipine treatment

目的采用血管弹性量化分析技术-血管回声跟踪技术(Echo-Tracking,ET技术)观察非洛地平对早期高血压患者动脉弹性功能的影响。方法首次诊断原发性高血压(WHO/ISH原发高血压诊断标准),最终符合实验要求56例纳入高血压治疗组,以血压水平正常范围内56人为健康对照组。高血压治疗组患者服用非洛地平(5～10 mg/d),随访24周,治疗前后测定收缩压、舒张压、脉压差及心率,并利用ET技术获取动脉弹性功能指标,包括僵硬度指数、颈动脉脉搏波传导速度、反射波增强指数、压力-应变弹性指数、动脉顺应性、颈动脉内膜中层厚度。结果①治疗前高血压治疗组的收缩压、颈动脉内膜中层厚度、僵硬度指数、颈动脉脉搏波传导速度、压力-应变弹性指数各项指标均值都比健康对照组高(P<0.05);动脉顺应性低于对照组(P<0.05),差异都有显著性意义。②高血压治疗组使用非洛地平24周后,收缩压、僵硬度指数、颈动脉脉搏波传导速度、压力-应变弹性指数比用药前降低,差异有显著性意义(P<0.05);动脉顺应性升高,差异有显著性意义(P<0.05);颈动脉内膜中层厚度用药前后比较统计学无差异(P>0.05)。结论①应用ET技术可无创、直观监测早期高血压患者动脉弹性功能减低。②非洛地平能显著改善早期高血压患者动脉弹性的作用,缓解动脉粥样硬化的发展。

Objective To study the effect of Felodipine on the arterial elasticity of patients with primary hypertension.Methods 56 patients with primary hypertension were treated with Felodipine.The systolic blood pressure（SBP）,diastolic blood pressure（DBP）,pulse pressure difference and heart rate were measured before and after treatment.The functional indexes of arterial elasticity including arterial stiffness parameter（β）,pulse wave velocity（PWV-β）,augmentation index（AI）,pressure-strain elastic modulus（Ep）,arterial compliance（AC） and intimal media thickness（IMT） of carotid were measured with colorful ultrasonograph and echo-tracking technique.Meanwhile,56 persons with normal blood pressure were selected as control group.Results The SBP,DBP,β,PWV-β,IMT and Ep of the hypertension group were higher than that of the control group,while the AC was lower than the control group significantly（P0.05）.24 weeks after felodipine treatment,the SBP,β,PWV-βand Ep value of the patients were significantly decreased compared with those before treatment（P0.05）,but IMT was not decreased（P0.05）.Conclusions The colorful ultrasonograph and echo-tracking technique can be applied to observe the arterial elasticity directly.Felodipine can improve the arterial elasticity in old patients with essential hypertension.