高血压病患者动态脉压与颈动脉粥样硬化的相关性研究

THE RELATIONSHIP BETWEEN AMBULATORY PULSE PRESSURE AND ATHEROSCLEROSIS IN ESSENTIAL HYPERTENSION

目的 研究高血压病患者24h动态脉压与颈动脉粥样硬化间的关系。方法 选择1、2级高血压病患者57例作为研究对象,并与21例年龄、性别与之无统计学差异的健康者作对照,对所有患者行动态血压监测,作颈动脉血管超声测量颈总动脉内膜-中层厚度、颈总动脉内径,局限性的内膜-中层厚度增厚≥1.3mm定义为斑块。结果 高血压病患者其24h脉压均值、白天脉压均值、夜间脉压均值均较对照组明显升高,2级高血压病组脉压大于1级高血压病组;高血压病患者内膜-中层厚度明显增厚,且随着斑块严重程度的增加,内膜-中层厚度逐渐增厚;直线相关分析显示:脉压尤其是夜间脉压与内膜-中层厚度及斑块明显正相关,内膜-中层厚度与斑块正相关。结论颈动脉内膜一中层增厚是动脉粥样硬化的早期表现,脉压,尤其是夜间脉压在评估早期动脉硬化方面有着重要意义。

Objective To describe the relationship between ambulatory pulse pressure and atherosclerosis of common carotid arteries. Methods We selected 57 never-treated essential hypertensive subjects, (29 were in stage 1, 28 were in stage 2)and 21 control subjects. 24 - hour arterial blood pressure monitoring was used to examine ambulatory pulse pressure. Intima-media thickness(IMT)of common carotid arteries,diameter and plaque was evaluated by ultrasonography,intima-media thickness? 1.3 mm was defined as plaque. Results Pulse pressure (including 24h, daytime, night - time pulse pressure)were obviously increased in essential hypertensive subjects than that in control,and increased significantly in stage2 than that in stagel; IMT were thicker in essential hypertension,and the prevalence of plaque increased from the lowest to the highest quintile of IMT, there was an increasing trend for IMT with the severity of plaque; there were positive correlation between pulse pressure(especially night - time pulse pressure), IMT and plaque. Conclusion IMT of common carotid arteries was early manifestation of atherosclerosis. Pulse pressure,especially night-time pulse pressure, has important significance to evaluate the early manifestation.