左室构型无改变高血压病人颈动脉弹性功能的超声检测价值研究

The Evaluation of Carotid Artery Elastic Function by Ultrasound in Essential Hypertension Patients without Change in Left Ventricular Patterns

目的应用超声检测技术分析评价左室构型无改变高血压病人颈动脉弹性功能的超声特征,探讨其对临床诊治高血压及早期预测高血压病人发生心、脑血管并发症危险因素的价值。方法入选大连大学附属中山医院门诊健康体检者及门诊或住院的高血压患者。对照组35例,其中男18例,女17例,年龄(56.3±14.8)岁。高血压组32例,均选择左室构型正常者,其中男17例,女15例,年龄(59.6±13.5)岁。应用二维及定量组织速度成像技术,分别检测对照组及高血压组受试者的颈动脉二维超声及定量组织速度成像相关参数。结果高血压组的经颈总动脉直径和脉压校正后的颈总动脉后壁峰值速度(Vimax)及经颈总动脉直径和脉压校正后的颈总动脉后壁加速度(Aci)均明显减低,与对照组比较差异有统计学意义;高血压组的经心率和脉压校正后的颈总动脉后壁加速时间(Ati)及经心率和脉压校正后的颈总动脉后壁减速时间(Dti)均明显缩短,与对照组比较差异有统计学意义;高血压组的颈动脉僵硬度(β)测值增大,与对照组比较差异有统计学意义;高血压组的颈动脉可扩张度(DC)测值减低,与对照组比较差异有统计学意义;高血压组的IMT测值与对照组比较差异无统计学意义。结论高血压病人在心脏左室构型尚未发生改变时其颈动脉的弹性功能已经减低,颈动脉弹性功能的改变早于颈动脉结构及心脏构型的改变。超声检测技术能够为评价高血压病人颈动脉弹性功能提供早期可靠信息。

Objective To evaluate the ultrasonic manifestations of the carotid artery elastic function in essential hypertension（EH） patients without change in left ventricular patterns using ultrasonic technique,probe into its value in providing information for clinical diagnosis and treatment in EH as well as for the prediction of risky factors of its complications in cardiovascular and cerebrovascular disease.Methods Thirty-two hypertension and 35 normotensives were selected from the healthcheckup population and patient both in out-patient and in-patient department of affiliated Zhongshan hospital of Dalian university.The controls was composed of 35 healthy volunteers aged（56.3±14.8） years including 18 males and 17 females.Hypertension group were 32 essential hypertension patients with normal left ventricular geometry,including 17 males and 15 females aged（59.6±13.5） years.Echocardiagraphic measurements of corotid atreries in two groups were detected by two-dimensional ultrsound and quantitative tissue velocity imaging technology.Results Vimax and Aci in the hypertension group decreased compared with the control group,There was significant difference among the groups;Ati and Dti in the hypertension group were decreased against the control group,There was significant difference among the groups;β values of the hypertension group increased,compared with the control group with statistical significance;The DC of the hypertension group decreased compared with the control group with statistical significance;IMT of the hypertension group showed no significant difference with that of the control group.Conclusion The carotid artery elastic function of the hypertensive patients had decreased before the change took place in the left ventricular patterns,and hence the change in the carotid artery elastic function precedes the change in carotid artery texture and the left ventricular patterns.Ultrasonic testing technique can provide early and reliable information for the evaluation of the carotid artery elastic function of the hypertensive patients.