不同血压亚临床血管病变的特点及其临床意义  

Significance of detecting with early stage subclinicalvascular alterations in different blood pressure levels

作　　者：梁立荣[1] 李新立[1] 吴成权[1] 许迪[1] 王震震[1] 钱卫冲[1] 廖静[1] 

机构地区：[1]南京医科大学第一附属医院心内科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2005年第2期101-104,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省自然科学基金资助项目(BK2002029)

摘　　要：目的:探讨不同血压水平动脉顺应性和颈动脉内膜-中层厚度(IMT)亚临床血管病变的特点及其临床意义。方法:分别用桡动脉脉搏分析仪和血管外超声检测69例正常血压者、42例正常高值血压者、87例1级高血压和38例2级以上高血压患者大动脉顺应性(C1)、小动脉顺应性(C2)和颈动脉IMT。结果:①随着血压水平的增高,C1和C2逐步减低,组间两两比较均有统计学差异(P<0.05)。颈总动脉IMT在正常高值组与正常血压组间差异无显著性(P>0.05),高血压l级及2级以上组IMT均增厚,与正常血压组和正常高值组比较有统计学差异(P<0.01);②卡方分析表明正常血压组、正常高值组和高血压组C1异常减退率分别为0%、1.4%、2.4%,组间无统汁学差异(P>0.05)。C2异常减退率在正常血压组、正常高值组和高血压组分别为23.3%、42.9%和77.9%,组间差异有显著性(P<0.05)。结论:小动脉顺应性C2降低早于血压升高、C1减退和颈动脉IMT增厚,提示C2减低能更早更敏感地反映不同血压水平亚临床血管病变。Objective: To investigate subclincal vascular alterations in artery compliance and carotid artery IMT(intima-media thickness) among subjects with different blood pressure levels. Methods: Subjects with normal blood pressure(n = 69), with high-normal BP(n = 42), with grade 1 hypertension(n = 87) and with grade 2 and above hypertension(n = 38) were enrolled in this investigation.Arterial compliance(C1-large artery and C2-small artery) was measured by HDI-2020 and common carotid artery IMT (CCAlMT) was determined by B-mode ultrasound. Results:Covariance analysis showed that C1 and C2 were decreased with the elevation of BP level.Significant differences of C1 and C2 were found between groups(P < 0.05). Patients with grade1, 2 and above hypertension had significant higher CCA IMT than subjects with normal and high-normal BP level(P < 0.01). Compared with normal BP group, no higher IMT was detected in high-normal BP group. Chi-square analysis revealed the clinical decreases of C1 were present in 0%, 1.4%,and 2.4% of normal,high-normal BP and hypertensive subjects respectively,but these differences did not reach statistical significance(P > 0.05). The prevalence of clinical decrease of C2 in normal,high-normal BP, and hypertensive subjects was 23.3%,42.9%, and 77.9% respectively(P < 0.05). Conclusions: The decrease of C2 can be demonstrated before the elevation of blood pressure,the decrease of C1 and the increase of CCAIMT, and may be as earlier and more sensitive index than the other two in reflecting subclincal vascular alterations among subjects with different blood pressure levels.

关 键 词：高血压 动脉顺应性 颈动脉内膜中层厚度 

分 类 号：R544.1[医药卫生—心血管疾病]