高血压病左心室几何构型改变对颈动脉弹性功能影响的研究

Effect of geometric configuration of left ventricle on elastic functions of carotid artery in patients with essential hypertension

目的探讨高血压病不同左心室构型条件下颈动脉的弹性功能。方法测量高血压病左心室正常构型组(A组),向心性重构组(B组),向心性肥厚组(C组),离心性肥厚组(D组)和正常对照组(E组)的颈总动脉收缩末期及舒张末期内径(CDs及CDd),计算颈总动脉内径扩张率(IDEcr)、僵硬指数(βcr)、扩张性((CDc r)、压力应变弹性系数(EPcr),双侧颈总动脉斑块厚度之和(CPT)并进行比较分析。结果 CDs为E组<B、C、D组,A组<C组(均P<0.01),A组<B、D组(P<0.05);CDd为E、A组<B、C、D组(P<0.01);CPT为E组<A、B、C、D组(P<0.01);IDEcr为A组>B组(P<0.01),E、D组>B组(P<0.05);βcr为E组<A、B、C、D组,A组<B组(均P<0 01),C、D组<B组,A组<D组(均P<0.05);CD为E组>A、B、C、D组(P<0.01),A组>B、C组(P<0 05);EPcr为E组<A、B、C、D组,A组<B组(均P<0 01),A组<C、D组<B组(均P<0.05)。结论高血压病左心室几何构型改变对颈动脉的弹性功能具有相应的影响;高血压病不同左心室几何构型阶段颈动脉的弹性功能可定量评估。

Objective To investigate the elastic functions of carotid artery in essential hypertension （EH） patients with different left ventricular geometric configurations. Methods Essential hypertensive patients with normal geometry of left ventricle （group A）, with left ventricular concentric remodeling （group B）, with left ventricular concentric hypertrophy （group C） and with left ventricular eccentric hypertrophy （group D）, and healthy subjects （group E） were included in the study. The carotid systolic di- ameter （CDs） and carotid diastolic diameter （CDd） were measured. The internal diameter expansion ratio （IDEcr）, carotid 13 stiff- ness index （ 13 cr）, carotid distensibility （CD）, carotid pressure strain elastic modulus （EPcr）, the plaques thickness of bilateral common carotid artery （CPT） were calculated. Results The CDs in group E was lower than that in groups B, C and D; CDs in group A was lower than that in groups C, B and D （P〈0.01or 〈0.05）. The CDd in groups E and A were lower than that in groups B, C and D （P〈0.01）. The CPT in group E was lower than that in groups A, B, C and D （P〈0.01）. The IDEcr in group A was higher than that in group B,（P〈0.01）; IDEcr in groups E and D was higher than that in group B （P〈0.05）. The 15 cr in group E was lower than that in groups A, B, C and D, in group A was lower than that in group B （P〈0.01）, in groups C and D were lower than in group B, in group A were lower than that in group D （P〈0.05）. The CD in group E was higher than that in groups A, B, C and D （all P〈0.01）,in group A was higher than that in groups B and C （P〈0.05）. The EPcr in group E was lower than that in groups A, B, C and D, in group A was lower than that in group B （P〈0.01）, in group A was lower than in groups C and D, was all lower than that in group B （P〈0.05）. Conclusion Elastic function of carotid artery is associated with geometric configuration of left ventricle in essential hypertension and they can be quantitatively evaluated.