降压程度对老年原发性高血压患者脑血管储备功能的影响  

Effect of different degrees of antihypertension on cerebral circulation storage in the senile patients with essential hypertension

作　　者：江文宇[1] 吕泽平[1] 杨珈玲[2] 庞国防[1] 胡才友[1] 韦德湛[2] 

机构地区：[1]广西壮族自治区江滨医院神经内科,广西壮族自治区南宁市530021 [2]广西壮族自治区江滨医院多普勒室,广西壮族自治区南宁市530021

出　　处：《中国临床康复》2005年第3期92-93,共2页Chinese Journal of Clinical Rehabilitation

基　　金：广西自然科学基金资助项目(桂科自:0007062)~~

摘　　要：目的:检测不同程度的降压水平对老年原发性高血压患者脑血管反应性的影响,探讨不同程度降压治疗对其脑血管储备功能的影响和效果。方法:选择1999-03/2003-12在广西壮族自治区江滨医院神经内科门诊就诊或病房的老年原发性高血压患者33例(观察组),男23例,女10例。选择同期本院健康体检自愿者健康老年人27例为对照组,男22例,女5例。对观察组及对照组老年人应用经颅多普勒(TCD)技术测定其脑循环血流动力学参数:平均峰流速(averagepeakforwardvelocity,Vm),屏气指数及脉动指数。结果:观察组降压前Vm上升率、屏气指数、脉动指数下降率犤(28.57±9.08)%,1.04±0.19,(16.69±5.46)%犦均明显低于对照组犤(37.70±10.36)%,1.41±0.58,(20.60±7.38)%犦(P<0.05～0.01),而两组Vm值比较,差异无显著性意义(P>0.05)。观察组第1次降压Vm上升率及BHI明显低于对照组(P<0.05～0.01),两组脉动指数下降率比较,差异无显著性意义(P>0.05);观察组第1次降压前后所有指标变化比较,差异无显著性意义(P>0.05)。观察组第2次降压后Vm上升率和BHI明显高于降压前(P<0.05);Vm上升率明显低于对照组(P<0.01)。结论:适当水平的降压治疗可有效改善老年原发性高血压患者脑血管对二氧化碳的反应性,改善其脑血管储备功能。AIM:To detect the effect of different degrees of antihypertension on the cerebrovascular reactivity of senile patients with essential hypertension,and investigate the influence and curative effect of different degrees of antihypertension on cerebral circulation storage. METHODS:Thirty-three senile patients with essential hypertension(23 males and 10 females,observation group) were selected from the outpatient department and wards of Department of Neurology,Jiangbin Hospital in Guangxi Zhuang Autonomous Region from March 1999 to December 2003.Twenty-seven healthy senile eople(22 males and 5 females,control group) were selected as controls from the outpatient department of the same hospital during the same period.The cerebral hemodynamics parameters of cerebral circulation,average peak forward velocity(Vm),breath-holding index(BHI) and pulsatility index(PI) in all the subjects were measured by transcranial Doppler(TCD) sonography. RESULTS:Before antihypertension,the ascending rate of Vm,BHI,descending rate of PI in the observation group[(28.57±9.08)%,1.04±0.19,(16.69±5.46)%respectively] were lower than those in the control group[(37.70±10.36)%,1.41±0.58,(20.60±7.38)%respectively](P< 0.05 to 0.01),but there was insignificant difference in Vm between the two groups(P >0.05).After antihypertension for the first time,the ascending rate of Vm and BHI were significantly lower in the observation group than in the control group(P< 0.05 to 0.01),while the descending rate of PI between the two groups was insignificantly different(P >0.05).After antihypertension for the second time,the ascending rate of Vm and BHI in the observation group were significantly higher than those before antihypertension(P< 0.05),and the former index in the observation group was significantly lower than that in the control group(P< 0.01). CONCLUSION:The cerebrovascular reactivity to CO2 or the cerebral circulation storage in senile patients with essential hypertension can be improved effectively by befitting antihypertension.

关 键 词：高血压 脑/血液供应 脑血管循环 超声检查 多普勒 经颅 

分 类 号：R544.1[医药卫生—心血管疾病]