高血压患者颈动脉结构和功能改变的超声研究

Ultrasonic study on the structural and functional changes of carotid artery in patients with hypertension

目的探讨高血压（HTN）伴左室肥厚（LVH）患者颈动脉重构的特点及两者之间的关系。方法140例受检者入选本研究，其中高血压非左室肥厚（NLVH）50例，高血压伴左室肥厚（LVH）50例，体检健康者对照组40例，分别测量颈动脉内-中膜厚度（CA—IMT）、斑块和斑块积分、弹性系数（EC）、僵硬系数（β）、顺应性（AC）以及颈总动脉（CCA）、颈内动脉（ECA）的血流动力学参数。结果与对照组比较，高血压组CA内径、CA—IMT、斑块检出率和斑块积分明显增加，而且颈动脉EC及β增高，AC降低，组间比较差异有统计学意义（P〈0．05）；血流动力学指标表现为收缩期峰值流速、舒张末期流速降低，搏动指数和阻力指数均增高，且均以LVH组改变最显著，组间比较差异有统计学意义（P〈0．05）。结论高血压患者CA—IMT、斑块增加、顺应性降低以及血流动力学改变与LVH密切相关。

Objective To investigate the characteristic of carotid artery remodeling of patients who suffered from hypertension （HTN） with left ventricular hypertrophy （LVH）. Methods One hundred and forty cases were chosen, 50 HTN patients without LVH （NLVH） , 50 HTN patients also with LVH （LVH）, 40 heahhy individuals. They were all assessed the carotid artery （CA）intima-media thickness （IMT） , plaque and plaque score, elasticity coefficient （ EC ） , stiffness coefficient （ [3 ） , compliance （ CA ） and hemodynamic parameters of common carotid artery （CCA） and internal carotid artery （ECA）. Results Compared with healthy individuals, the change of the CA internal dameter and CA-IMT,plaque detectable rate and score,EC and β were all increased, but the CA decreased. The differences between groups were significant （P 〈 0.05 ）. In terms of the hemodynamic parameters, peak systolic velocity （PSV） and end diastolic velocity（EDV） were reduced, pulsatility index（PI） and resistance index（RI） rised（P 〈0.05）. Conclusions As to HTN patients, the remodeling and functional change of CA are closely related with the LVH.