老年原发性高血压病患者左心室重构与颈动脉粥样硬化相互关系的研究

Study on the correlation between left ventricular reconstruction and carotid arterial atherosclerosis in aged patients with essential hypertension

目的 探讨老年原发性高血压病患者左心室重构与颈动脉粥样硬化间的关系。方法 老年原发性高血压病患者 12 0例 ,依据左心室心肌重量指数分为左心室肥厚 (LVH)组和非左心室肥厚 (NLVH)组 ,并选取 4 0例健康老年人为对照组 ,使用彩色多普勒超声仪检查双侧颈总动脉 (CCA)、颈内动脉 (ICA)、颈外动脉 (ECA)的管腔内径 (D)、内膜中层厚度 (IMT)及左心室各相关参数。结果 原发性高血压病患者颈动脉粥样硬化斑块的检出率显著高于对照组。LVH组和NLVH组患者CCA、ICA、ECA阻力指数均高于对照组 ,LVH组又高于NLVH组。结论 颈动脉粥样硬化的发生与原发性高血压病左心室重构的发生密切相关 ,IMT D值、IMT值是早期诊断颈动脉粥样硬化程度的敏感指标。

Objective To investigate the correlation between left ventricular (LV) reconstruction and carotid arterial atherosclerosis in aged patients with essential hypertension.Methods One hundred and twenty aged patients with essential hypertension were divided into two groups according to myocardial mass index of the LV as left ventricular hypertrophy group(LVH) and non left ventricular hypertrophy group(NLVH),and 40 healthy aged persons were selected as normal control. A Color Doppler Ultrasound system was used to investigate the internal diameter(D), the intimal medial thickness(IMT) and the related parameters of left ventricle.Results The positive rate of atherosclerotic patches found in the patients with essential hypertension was remarkably higher than that in the normal controls.Furthermore,hemodynamic investigation showed that blood flow resistance index(RI) values of common carotid artery(CCA),internal carotid artery(ICA) and external carotid artery(ECA) of both LVH and NLVH groups were markedly higher than those of normal control,while the values of these parameters of the LVH group were higher than those of the NLVH group.Conclusions The values of IMT/D and IMT are sensitive indicators which can be used to evaluate the degree of atherosclerosis of carotid artery at the early phase. The atherosclerosis of carotid artery was significantly correlated with the structural reconstruction of LV in the aged patients with essential hypertension.