高血压左室不同构型与脑血流动力学改变的关系

Left ventricular varying pattern and the change of cerebral hemodynamics in hypertension

目的 探究高血压左室不同构型与脑血流动力学改变的关系。方法 采用超声心动图方法，将91例高血压分成正常构型组、向心性肥厚组和离心性肥厚组；采用经颅多普勒技术检测各组脑血流动力学的参数。结果 （1）正常构型组脑动脉的收缩期峰值流速（Vs）、平均流速（Vm）、舒张末期流速（Vd）明显高于其它两组和正常对照组（P＜0．05～0．001）；脉动指数（PI）明显低于其它两组（P＜0．05～0．001），与正常对照组接近（P＞0．05）。（2）向心性肥厚组的脑动脉血流速度各参数与正常对照组接近（P＞0．05），但PI显著高于正常对照组（P＜0．05和＜0．01）。（3）离心性肥厚组的脑动脉血流速度各参数显著低于其它两组和正常对照组（P＜0．05～0．001），而PI显著高于其它两组和正常对照组（P＜0．02～0．001）。结论高血压左室肥厚不同构型的演变过程中，伴随有明显的脑血流速度变化。

Objective To study the relationship between the remodelling patterns of left ventricle and the changes of cerebral hemodynamics in patients of hypertension． Methods Echocardiography was used to study the left ventricular patterns in 91 essential hypertensive patients which were classified into three groups normal geometry NG concentric hypertrophy CH and eccentric hypertrophy EH． The parameters of cerebral hemodynamics in above three groups patients were detected by transcranial Doppler ultrasound． Results 1In NG group the systolic peak velocity Vs mean velocity Vm and end－diastolic velocity Vd of cerebral arteries were significantly increased than those in CH EH and normal control NC groups P＜0．05～0．001． Pulsatility index PI was lower than that in CH and EH groups P＜0．05～0．001 approximated to that in NC group P＞0．05． 2In CH group Vs Vm and Vd were closed to those in NC group P＞0．05 but PI was more increased than that in NC group P＜0．05or P＜0．01． 3In EH group Vs Vm and Vd were significantly decreased P＜0．05～0．001 and PI was significantly increased than those in NG CH and NC group P＜0．02～0．001． Conclusion In the successional variation of left ventricular patten in patients of hypertension the significant changes of cerebral arterial flow velocity were associated．