老年单纯收缩期高血压的动脉弹性功能变化

Arterial Elastic Function Change in Elderly Patients With Isolated Systolic Hypertension

目的 比较老年正常血压者、单纯性收缩期高血压 (ISH)与非单纯性收缩期高血压 (NISH)患者的动脉弹性功能 ,了解不同类型老年高血压大动脉和小动脉弹性的差别。方法 选择 5 0例健康老年人 (男女各 2 5例 ,平均年龄 6 8± 5岁 )和 84例老年高血压病人 (男性 39例 ,女性 4 5例 ,平均年龄 6 8± 5岁 ) ,其中单纯性收缩期高血压 (ISH) 6 4例 ,非单纯性收缩期高血压 (NISH) 2 0例。使用DO2 0 2 0动脉功能测定仪检测桡动脉脉搏波形和动脉弹性指数C1和C2 。结果 ISH大动脉弹性指数C1(7± 2 1ml/mmHg× 10 )低于NISH组 (9 2± 3 1ml/mmHg× 10 )和正常血压对照组(12 9± 4ml/mmHg× 10 ) ,P <0 0 1;ISH小动脉弹性指数C2 (2 6± 2 2ml/mmHg× 10 0 )与NISH(2 7± 2 5ml/mmHg× 10 0 )无显著差别 ,均低于正常血压对照组 (4 3± 2 5ml/mmHg× 10 0 ) ,P <0 0 1;在正常血压对照组 ,动脉弹性指数与脉压显著负相关 (C1:r=- 0 6 2 7,P <0 0 0 1;C2 :r =- 0 389,P <0 0 0 1) ,但在ISH则并不相关 (C1:r =- 0 10 5 ,P =0 4 10 ;C2 :r =- 0 2 0 3,P =0 10 8)。

Objective To evaluate the elastic function of large and small artery among the health subjects, the patients with the different type of hypertension in the elderly, ie ISH and NISH. Methods Fifty healthy elderly subjects (25 males and 25 females, average age 68±5 years) and 84 patients with hypertension (39 males and 45 females, average age 68±5 years) were enrolled, consisting 64 ISH and 20 NISH. Radial arterial pulse wave and arterial elastic index C 1 and C 2 were measured by DO2020 arterial pulse contour instrument. Results Arterial capacitive compliance(C 1) was significantly lower in ISH group(7±2.1 ml/mmHg×10) than in NISH group(9.2±3.1 ml/mmHg×10), P <0 01, and control subjects(12 9±4 ml/mmHg×10), P <0 01 However, oscillatory compliance(C 2) was similar in ISH and NISH group(2 6±2 2 ml/mmHg×100 versus 2 7±2 5 ml/mmHg×100, P >0 05), both were significantly lower than control group(4 3±2 5 ml/mmHg×100, P <0 01. No correlation between pulse pressure and artery elastic indexes(C 1: r =-0 105, P =0 410; C 2: r =-0 203, P =0 108) in the ISH group was found, whereas in the control group an inverse relationship between pulse pressure and the artery elastic indexes was demonstrated(C 1: r =-0 627, P <0 001; C 2: r =-0 389, P <0 001)? Conclusion Elastic dysfunction in large and small arterial was present in the elderly patients with ISH.