动态动脉硬化指数与高血压靶器官损伤的相关性及动态观察

Correlation and dynamic observation of ambulatory arterial stiffness index and target organ damage of hypertension

目的通过对高血压患者降压治疗,观察动态动脉硬化指数(AASI)及靶器官损伤的变化,探讨AASI与靶器官损伤的相关性及动态改变。方法筛选300例初治高血压患者,严格控制血压后,随访1年完成动态血压及靶器官损伤的检查,观察AASI及靶器官损伤的动态变化。结果经过1年降压治疗后,AASI呈逐步下降趋势,与治疗前对比,第6个月出现下降,1年后出现显著下降;治疗前及治疗后AASI均与颈动脉内膜-中层厚度(IMT)、尿微量清蛋白(UMA)、肾血管阻力指数(RRI)、左心室质量指数(LVMI)呈独立正相关,与内生肌酐清除率(Ccr)呈独立负相关;多元线性回归分析显示,IMT、UMA、RRI、Ccr、LVMI与AASI均有显著相关性。治疗1年后,IMT、UMA、RRI、Ccr及LVMI均得到改善(P<0.05)。结论 AASI可以作为评估高血压动脉硬化和预测高血压靶器官损伤的指标。

Objective To observe the changes of ambulatory arterial stiffness index （AASI） and target organ damage （TODs） after antihypertensive treatment in hypertensive patients. Methods A total of 300 cases of newly diagnosed hypertension were screened out and after strictly controlling blood pressure, completed the ambulatory blood pressure and target organ damage inspection by 1-year follow-up. The dynamic changes of AASI and target organ damage were observed. Results After 1-year anti- hypertensive therapy, AASI showed the gradually descending trend,compared with before treatment,began to decline at 6 months, decreased significantly after 1 year;AASI showed the independent positive correlation with the intima-media thickness（IMT） of carotid artery,urine microalbumin（UMA）, renal vascular resistance index（RRI） and left ventricular mass index（LVMI）, and independent negative correlation with endogenous creatinine clearance rate（Ccr） before and after treatment; the multiple linear regression analysis showed that IMT, UMA, RRI, Ccr and LVMI had significant correlation with AASI. After 1 year of therapy, IMT, UMA, RRI,Ccr,LVMI had shown some improvement（P〈0.05）. Conclusion AASI can be used as an indicator for evaluating arteriosclerosis and predicting the target organ damage in hypertension.