高血压合并大脑中动脉狭窄患者脑血管反应性与脑梗死的相关性研究

On the Relationship between Cerebrovascular Reactivity and Cerebral Infarction in Essential Hypertension with Middle Cerebral Arterial Stenosis

目的探讨高血压合并大脑中动脉狭窄患者的脑血管反应性与脑梗死的相关性.方法选择对象系在吉林省人民医院门诊或住院的老年高血压患者,除外合并糖尿病、高脂血症者,应用TCD测定大脑中动脉血流速度,取合并大脑中动脉狭窄的患者120例及健康对照组30例,依据头部CT或头部MRI的表现,分为症状性梗死组、无症状性梗死组、单纯血管狭窄组、高血压不合并血管狭窄组(单纯高血压组)、健康对照组,利用CO2屏气试验监测脑血管反应性,计数资料间比较使用χ2检验.结果与健康对照组比较,高血压组患者脑血管反应性明显降低(P<0.05),在高血压组中,梗死组脑血管反应性降低的更为显著(P<0.01).结论高血压患者脑血管反应性明显降低,高血压合并颅内血管狭窄的患者脑血管反应性进一步降低,更易发生脑梗死.

Objective To evaluate the relationship between cerebrovascular reactivity and cerebral infarction in patients with essential hypertension complicated with middle cerebral arterial stenosis.Method Outpatient or hospitalized hypertensive patients in Jilin Province People＇s Hospital who had been exclude diabetes and hyperlipidemia,were selected and their blood flow velocities were measured with TCD.120 Patients complicated with middle cerebral artery stenosis were determined as the subjects and 30 healthy people were taken as the control group.They were divided into symptomatic infarction group,asymptomatic infarction group,simple vascular stenosis group,hypertension with vascular stenosis group（in hypertension group）and healthy control group based on the examination of head CT or head MRI,the CO2 breath-holding test was applied to monitor the cerebrovascular reactivity,and the count data were compared using the χ2 test.Results Compared with the healthy control group,the cerebrovascular reactivity of hypertensive patients was significantly lower（P0.05）,and the cerebrovascular reactivities in the hypertension group and the infarction group decreased more significantly（P0.01）.Conclusion The cerebrovascular reactivity of hypertensive patients was significantly reduced and that of hypertensive patients with intracranial vascular stenosis was further reduced,indicating that it is more likely for the patients to suffer from cerebral infarction.