血管回声跟踪技术评价不同血压水平对颈动脉内皮功能的影响

Evaluation on the effects of different blood pressure levels on carotid endothelial function by echo-tracking imaging technology

目的:应用血管回声跟踪(ET)技术定量评价不同血压水平对颈动脉内皮功能的影响。方法:选择高血压组(HP组)50例、正常高值血压组(HN组)30例和正常血压组(NP组)30例,常规二维超声测量颈动脉内膜中层厚度(IMT)和ET技术检测颈动脉弹性参数(Eρ、β、AC、AI、PWVβ),并进行统计学分析。结果:3组研究对象均合并较多的心血管危险因素,HN组较NP组排除混杂因素前IMT、Eρ、PWVβ差异值有显著性而排除混杂因素后仅PWVβ值差异显著(P=0.04),HP组较NP、HN组于排除混杂因素前后各硬化参数差异均显著。结论:血压升高与血管内皮功能损伤密切相关,但正常高值血压本身对颈动脉弹性无明显影响,其所合并的危险因素在动脉硬化及血压升高过程中起到重要作用;在高血压早期,即使颈动脉未发生明显病理形态学改变,血压已成为血管内皮功能损伤的独立危险因素。

Objective To evaluate the effects of different blood pressure levels on carotid endothelial function by echo-tracking（ET） imaging technology.Methods A total of 110 subjects were divided into three groups： hypertension group（HP group） with 50 subjects,high-normal blood pressure group（HN group） with 30 subjects,and normal blood pressure group（NP group） with 30 subjects.Conventional two-dimensional ultrasound was performed to detect the intima-media thickness（IMT）,and ET imaging technology was performed to detect the parameters of carotid sclerosis（Eρ,β,AC,AI,PWVβ）.Results All the subjects in the three groups were accompanied with several cardiovascular risk factors.HN group had significant higher IMT,Eρ,PWVβ values than NP group before excluding confounding factors,but only PWVβ value was significant after excluding confounding factors（P = 0.04）.The differences of all parameters of carotid sclerosis between HP and NP group,HP and HN group were significant regardless of confounding factors.Conclusion The ascension of blood pressure is closely related to vascular endothelial dysfunction.High-normal blood pressure itself has no obvious effects on carotid elasticity but the combined risk factors may play an important role in sclerosis of artery and development of hypertension.In the early stage of hypertension,the appearance of carotid endothelial dysfunction is much prior to the morphological change and the blood pressure has become an independent risk factor.