高血压合并动脉粥样硬化与大动脉缓冲功能关系的研究

Study of relationship between atherosclerosis and large arterial buffering function in patients with essential hypertension

目的 研究高血压病 (EH)合并动脉粥样硬化患者大动脉缓冲功能的改变。方法 选择 3 13例EH患者 ,其中男性 2 3 0例 ,女性 83例 ,平均年龄 ( 5 8.5± 10 .1)岁。应用脉搏波速度 (pulsewavevelocity ,PWV)自动测量系统测定颈动脉 股动脉PWV作为反映大动脉节段扩张性的参数 ;B型超声对颈动脉进行扫查 ,动脉粥样硬化的定义为内膜 中层厚度≥ 1.3mm。颈动脉横断面顺应性和容积扩张性作为评价大动脉缓冲功能的指标。结果 3 13例EH患者合并颈动脉粥样斑块者 12 0例。与未合并颈动脉粥样硬化患者相比 ,EH合并颈动脉粥样硬化患者收缩压 [( 14 9.76± 2 0 .2 0 )mmHg比( 14 1.62± 18.94 )mmHg]、脉压 [( 61.72± 18.94 )mmHg比 ( 5 2 .84± 14 .5 8)mmHg]和PWV[( 12 .91±2 .93 )m/s比 ( 10 .78± 2 .0 2 )m/s]显著升高 (P均 <0 .0 0 1) ;颈动脉横断面顺应性 [( 64.68± 4 0 .5 2 ) 10 -3·mm2 /mmHg比 ( 81.5 5± 63 .4 5 ) 10 -3·mm2 /mmHg]和容积扩张性 [( 1.71± 1.4 0 ) 10 -3·mmHg比( 2 .3 9± 2 .0 1) 10 -3·mmHg]显著降低 (P均 <0 .0 5 )。结论 EH合并颈动脉粥样硬化者大动脉弹性减退 ,缓冲功能显著降低。

Objective To explore large arterial buffering function in patients with essential hypertension (EH) who suffered atherosclerosis. Methods 313 patients with were selected, 230 male, 83 female, mean age 58.5±10.1 years. Automatic pulse wave velocity (PWV) system was used to examine carotid-femoral PWV that acted as an index to reflect large arterial distensibility. B-mode ultrasound was applied to scan carotid artery, common carotid artery intima-media thickness ≥1.3 mm was defined as atherosclerosis. Carotid cross-sectional compliance and volume distensibility were also used as indices to reflect large arterial buffering function. Results Among 313 patients with EH 120 presented carotid atherosclerosis. Systolic blood pressure (149.76±20.20 mm Hg vs 141.62±18.94 mm Hg), pulse pressure (61.72±18.94 mm Hg vs 52.84±14.58 mm Hg ) and PWV (12.91±2.93m/s vs 10.78±2.02 m/s) in EH patients with carotid atherosclerosis were significantly higher (P<0.001, respectively) and cross-sectional compliance of carotid artery (64.68±40.52 10 -3·mm2/mm Hg vs 81.55±63.45 10 -3·mm2/mm Hg) and volumic distensibility (1.71±1.40 10 -3·mm Hg vs 2.39±2.01 10 -3·mm Hg) were significantly lower (P<0.001, respectively) than those in patients without carotid atherosclerosis. Conclusion Large arterial elasticity and buffering function decreased in EH patients with carotid atherosclerosis.