老年高血压患者颈动脉病变与血压变异性关系

Relationship between Carotid Artery Lesions and Blood Pressure Variability in Elderly Patients with Hypertension

目的:研究老年高血压患者颈动脉病变与血压变异性关系。方法:选择佳木斯市中心医院从2019年2月-2021年12月收治的100例老年高血压患者。所有受试者均开展颈动脉彩超检查,将受试者按照是否存在斑块分作颈动脉病变组(IMT值≥1.3 mm)36例及颈动脉正常组64例。比较两组颈动脉形态学指标及血压变异性指标水平。并以Pearson相关性分析明确老年高血压患者IMT、阻力指数(RI)与血压变异性指标的相关性。此外,比较两组血流动力学指标水平。结果:颈动脉病变组颈内动脉、颈总动脉RI分别均高于颈动脉正常组(P<0.05)。颈动脉病变组各项血压变异性指标水平均高于颈动脉正常组(P<0.05)。经Pearson相关性分析发现,老年高血压患者IMT、RI与各项血压变异性指标均呈正相关(P<0.05)。颈动脉病变组颈内动脉、颈总动脉最大剪切率(SR)分别为(263.21±24.20)、(230.48±20.34)s^(-1),均低于颈动脉正常组的(321.38±40.25)、(311.78±28.47)s^(-1),且颈动脉病变组颈内动脉、颈总动脉收缩期峰值流速(PSV)分别为(46.71±5.22)、(57.24±8.01)cm/s,均低于颈动脉正常组的(56.20±6.34)、(74.12±9.33)cm/s(P<0.05)。结论:老年高血压患者颈动脉病变的发生、发展可能和血压变异性有关。

Objective:To study the relationship between carotid artery lesions and blood pressure variability in elderly patients with hypertension.Method:A total of 100 elderly patients with hypertension admitted to Jiamusi Central Hospital from February 2019 to December 2021 were selected.All subjects underwent carotid color ultrasound examination,and were divided into carotid artery lesion group (36 cases) and normal carotid artery group (64 cases) according to the presence of plaque (IMT≥1.3 mm),and the levels of carotid artery morphology and blood pressure variability were compared between the two groups.Pearson correlation analysis was used to determine the correlation between IMT,RI and blood pressure variability in elderly patients with hypertension.In addition,the levels of hemodynamic indexes were compared between the two groups.Result:RI of internal carotid artery and common carotid artery in carotid artery disease group were higher than those in normal carotid artery group (P<0.05).The blood pressure variability levels of carotid artery disease group were higher than those in normal carotid artery group (P<0.05).Pearson correlation analysis showed that IMT,RI were positively correlated with various blood pressure variability indexes in elderly hypertension patients (P<0.05).SR of internal carotid artery and common carotid artery in carotid artery lesion group was (263.21±24.20) s^(-1)and (230.48±20.34) s^(-1),respectively,lower than (321.38±40.25) s^(-1)and (311.78±28.47) s^(-1)in normal carotid artery lesion group.The PSV of internal carotid artery and common carotid artery in carotid artery lesion group was (46.71±5.22) cm/s and(57.24±8.01) cm/s,respectively,lower than (56.20±6.34) cm/s and (74.12±9.33) cm/s of normal carotid artery group (P<0.05).Conclusion:The occurrence and development of carotid artery lesions in elderly patients with hypertension may be related to blood pressure variability.