老年高血压患者中心动脉压与周围动脉压及左心室功能的关系

Relationship of Central Aortic Pressure to Peripheral Arterial Pressure and Left Ventricular Function in Elderly Hypertension Patients

目的:探讨老年高血压患者中心动脉压与周围动脉压及左心功能的关系。方法:选择我院行左心导管术的老年患者84例,根据患者袖带法测定的肱动脉血压情况分为高血压组(52例)和非高血压组(32例),用导管测定两组患者升主动脉处中心动脉收缩压(CSP)和中心动脉舒张压(CDP);应用超声多普勒测定患者舒张期室间隔厚度(IVST)、左室后壁厚度(LVPWT)、舒张末期左室内径(LVDd)、左室射血分数(LVEF)等反映左心功能的指标。结果:①两组对象CSP均明显高于袖带法测定的肱动脉收缩压(P<0.05);CDP与肱动脉舒张压无统计学差异(P>0.01);高血压组CSP及CDP均高于非高血压组(P<0.05)。②高血压组IVST、LVPWT显著高于非高血压组(P<0.05);LVDd、LVEF显著低于非高血压组(P<0.05)。③随着心功能的降低,高血压患者中心动脉脉压升高,反射波增强,压力增高,压力增强指数比值增大(P<0.05)。结论:袖带法测量的肱动脉血压不能完全代表中心动脉血压,高血压患者中心动脉压的改变可以反映患者左心功能情况,中心动脉脉压升高、增强指数增加可能对高血压患者心血管事件有一定的预测价值。

Objective： To investigate the relationship between central aortic pressure and peripheral arterial pressure or left ventricular function of elderly hypertension patients.Methods： A total of 84 cases of left heart catheterization patients in our hospital were divided into the hypertensive group（52 cases） and non-hypertensive group（32 cases） according to brachial artery blood pressure,the central aortic systolic blood pressure（CSP） and central aortic diastolic blood pressure（CDP） were measured with catheterization;left ventricular function indicators such as diastolic interventricular septal thickness（IVST）,left ventricular posterior wall thickness（LVPWT）,end-diastolic left ventricular diameter（LVDd）,and left ventricular ejection fraction（LVEF） were determined by ultrasound Doppler.Results： ① CSP were significantly higher than the brachial artery systolic blood pressure determined by the cuffmethod（P0.05）,but there was no significant difference between the CDP and brachial artery diastolic pressure（P0.01）;CSP and CDP were higher in hypertension group vs.that respectively in non-hypertensive group（both P0.05）.② In hypertension group,IVST and LVPWT were significantly higher than in non-hypertensive group（P0.05）,and LVDd and LVEF were significantly lower than in non-hypertensive group（P0.05）.③ Along with the decreasing of heart function,the central aortic blood pressure was increasing,thus the pressure augmentation index ratio also increased（P0.05）.Conclusion： The cuff measurement of brachial artery blood pressure can＇t be fully representative of the central aortic blood pressure,and changes of central aortic blood pressure reflects the changes of left ventricular function in patients with hypertension.Increased central aortic blood pressure and pressure augmentation index ratio may have some predictive value for cardiovascular events in hypertension patients.