超声评价早期原发性高血压患者血管内皮功能颈动脉内-中膜厚度及左室舒缩功能

Ultrasound evaluation of early primary hypertension patients with carotid artery endothelial function,intima-media thickness and left ventricular diastolic function

目的分析超声评价早期原发性高血压患者血管内皮功能、颈动脉内-中膜厚度及左室舒缩功能的临床价值。方法选取2013年1月~2014年12月确诊为早期原发性高血压的患者48例作为研究组,另选同期健康体检志愿者48例作为对照组。对比两组肱动脉基础内径、反应性充血引起的是内皮依赖性血管扩张值（FMD）、是非内皮依赖性血管扩张值（NMD）、血管内皮功能、颈动脉内-中膜厚度（IMT）、斑块检出率等高频超声检测结果、心脏常规测值以及左室壁平均峰值应变及应变率。结果研究组静状态下肱动脉基础值、IMT显著高于对照组,FMD显著低于对照组,具有统计学差异（均P〈0.05）;研究组室间隔舒张末期厚度（IVSTd）、左室后壁舒张末期厚度（LVPwTd）两项数据显著大于对照组,具有统计学差异（P〈0.05）;研究组舒张早期峰值流速（Ve）显著小于对照组,舒张晚期峰值流速（Va）显著大于对照组,Ve/Va显著低于对照组,具有统计学差异（均P〈0.05）;研究组应变率（mSLs、mSrLe）以及mSrLe/mSrLa均显著低于对照组,mSrLs、mSrLa显著高于对照组,具有统计学差异（均P〈0.05）。结论高频超声检查能有效无创地评价患者血管内皮功能、颈动脉内-中膜厚度等,为患者临床治疗提供更多、更准确的无创诊断信息。

Objective To investigate the clinical value of ultrasonography in assessing early primary hypertension patients with vascular endothelial function,carotid artery in-media thickness and left ventricular systolic and diastolic function.Methods 48 early primary hypertension patients in our hospital from Jan 2013 to Dec 2014 for treatment and diagnosis were selected as study group.48 healthy volunteers at the same period were selected as the control group.The high frequency ultrasound measurements and conventional cardiac left ventricular wall average peak strain and strain rate were observed.Results The brachial artery value and IMT at static state of study group was significantly higher than that of control group.FMD of study group was significantly lower than that of the control group.The difference between the two groups were statistically significant（the values of t were 3.598,7.945,8.868 respectively,all P〈0.05）.IVSTD and LVPwTD of study group were significantly greater than that of control group（all P〈0.05）.VE in the study group was significantly less than that in the control group.VA of the study group was significantly greater than that of control group.VE/VA of the study group was significantly lower than that of control group.mSLs,mSrLe and mSrLe/mSrLa of study group were significantly lower than that of control group.mSrLs,mSrLa of study group were significantly higher than that of the control group（all P〈0.05）.Conclusion High frequency ultrasonographies can effective non invasively assess vascular endothelial function and carotid arterial intima-media thickness and provide accurate non invasive diagnostic information for clinical treatment of patients.